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OFFICIAL    MONTHLY    BULLETIN 

ESTABUSHED  JULY.    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  as  Second  Ctass  Matter,  October  27,   1921 
at  the   Pos  (.office  at   Jacksonville,    Florida,   Under   the  Act   of  August    24,    19 1 Z 

Thia  Bulletin  will  He  sent   to  any  address  in  the  State   free  of  charge. 



Vol.  22  JANUARY,    1930  No.    1 


Edited    by 

STEWART  C.  THOMPSON,  D.P.H.,  Member 
American  Medical  Editors'  and  Authors'  Asan. 


SPECIAL  ARTICLES 

CONCLUSIONS— Reid 

THE  GERM  MARKET— Brink 

BUSINESS      IS      GOOD  —  Filby 

ECHOES  OF  BOARD  MEETING— Hanson 

FT.  PIERCE  DOCTOR  CONGRATULATED— Thompson 


HENRY  HANSON,   M.  D..  STATE  HEALTH  OFFICER 


FLORIDA   STATE    BOARD    OF    HEALTH 


Chas.    H.    Mann.    Prea. 
Jacksonville 


BOARD  MEMBERS 


ft 


Ma=on    Smith. 
Tampa 


M.    I  J. 


Wm,  D.  Nobles, 
■    Pens a col  a 


M.  D. 


STATE  HEALTH  OFFICER 

Henry   Hanson,    M.    O. 

BUREAUS  AT  JACKSONVILLE  DIRECTORS 


Diagnostic   Labors  tones 
•Vital    Statistics- 


Pau]  Eaton,  M.   D. 
Stewart   G.   Thompson.  D. 
—    F.  A.  Brink.  M.  D. 


Communicable   Disease*. 

Engineering.^—— , — — — - — .,..n - — - —   Ellsworth  L.   Filby.  C  .E 

Child  Hygiene  end  Public  Health  Nursing —   Laurie  Jean  Reid,  R.  N 

Accounting ___.   Screven   Doziet 

Crippled   Children    . .,    .    , ______________   F.   L.   Fort,   M.   D. 


P.  H. 


■5  50   Local  Registrars    (County  list   furnished  on  request!. 

•Registration    Inspector—- — — — . — , Anna  C-  Emmons 

Drug  Store   Inspector : __    H*  R.  Monroe 

Drug  Store    Inspector , W.  A.   Maboney 


LABORATORIES 


.  ■  r 


Jacksonville-. 
Miami- 


Pen  sa  cola — . 
TaMahassee_ 
Tampa 


Paul  Eaton.  M.    D. 
E.    rt.     I'uweil 
Janie  B.  Currie,  B.  S. 
Elizabeth  Byrd,  B.  S. 
H.   D.  Venters.  B.  3. 


MEDICAL  OFFICERS 


DeP_mal_     Springs 

Jack  ion  vi  1  Le 

Melbourne . — 

Ta  1  _  a  h  ft  a  »  ee — 

T*m  £*___,__«__, 


_Z„ 


C.     W.     McDonald,     M.    D. 
B.  C.   Wilson.   M.   D 
W.    A.    Clajtion.    M.    D. 
A.    P.    Harrison.    M.    D. 
Chas.  W,  Pease.   M.  D. 


DISTRICT  SANITARY    OFFICERS 


Tampa.. 


Jacksonville.. 
Miami-. 
Oca  la 


Orlando— 

Punta  Got  da 
Tallahassee — 
Ta  m  pa 


.  *V.  B.   Lamoureux.  C.   E. 
.     Fred   A.    Safay 

George  B.   Reed 
«   C,  A.   Hollo  way 

Russell  Broughman 
..  C.  A.  Renney 
.    C.  N.  Hobba 
-   D.  H.  Osbum 
'Assistant  Engineer 


PUBLIC  HEALTH  NURSES 


Lake  City_ 

Tajnpa 

Arcadia.. 


DeFuniak    Springs 

Eden.    R.    F.    D.    Jensen- 
Lake   Cfty__  _...__. 

M  a  di  son — _*__~ 

Ma  r  i  a  n  n  a .— — , B 

Ruskln 

Starke 


•Clio    McLaughlin,    R.    N. 
"Harriet     I.    Sherman.    R.    N. 

Jule   Craves,   R.   N. 

Nanna  Colby.    R.    N. 

Sarah    Ida     Richards.    R.    N. 

Frances  Hall.  R.   N. 

Thora    Roberts.    R.    N. 

-  Elizabeth   Hixon.  R.   N. 
.    Joyce  Ely,   R.  N. 

-  Mary   G.   Dodd.  R.   N 

*  Field   Supervisor 


FLORIDA  STATE  BOARD  OF  HEALTH 


ADMINISTRATION 
Henry  Hanson,  M.  D.t  State  Health  Officer 

ECHOES    FROM    THE    BOARD    MEETING 

The  meeting  of  the  State  Board  of  Health  held  on  the  morning 
of  December  9th  had  an  additional  significance  for  the  Secretary  be- 
cause of  the  fact  that  just  twenty  years  ago  on  the  morning  of  Decem- 
ber 9  th  he  took  up  his  first  duties  with  the  Florida  State  Board  of 
Health  in  the  capacity  of  Director  of  the  Laboratory.  It  is  curious 
that  in  a  measure  the  State  Board  of  Health  finds  itself  in  a  condition 
similar  to  that  of  twenty  years  ago  in  having  outgrown  its  quar- 
ters. The  growth  in  activities  has  kept  pace  with  the  growth  of  the 
State,  even  though  there  has  not  been  a  corresponding  provision  of 
space  to  enable  the  staff  to  work  with  maximum  efficiency.  At  that 
time  our  Venerable  State  Health  Officer,  the  late  Dr.  Joseph  Y.  Por- 
ter, realized  that  there  was  a  great  future  for  the  state  and  adopted 
a  program  of  health  conservation  to  which  end  he  planned  and  built 
the  present  building  and  established  branch  laboratories  at  strategic 
points  in  conformity  with  the  transportation  facilities  as  they  could 
then  be  foreseen.  Under  his  wise  guidance  the  work  prospered  and  his 
staff  grew,  first  by  additions  to  the  Field  Staff,  the  antecedent  of  the 
Bureau  of  Communicable  Diseases,  then  the  initiation  of  public  health 
nursing,  first  in  the  nature  of  tuberculosis  nursing  soon  to  be  followed 
by  the  establishment  of  a  section  of  Vital  Statistics  and  later  the  em- 
ployment of  a  Sanitary  Engineer. 

The  different  activities  enumerated  above  are  now  developed 
into  Bureaus,  each  with  its  Director.  The  advance  in  Public  Health 
activities  throughout  the  country  places  an  increasing  demand  for  skill- 
ed and  trained  workers,  and  for  specialists  in  each  field.  No  one  per- 
son can  adequately  cover  more  than  one  field  in  the  modern  advanc- 
ing health  work. 

One  of  the  objectives  of  our  present  Governor  is  to  build  up  an 
efficiently  effective  health  department,  to  promote  preventive  medi- 
cine to  its  fullest  extent  without  encroaching  unduly  in  the  field  of 
therapeutics  or  curative  medicine.  The  sphere  of  a  health  department 
is  prophylaxis — to  protect  people  from  contracting  communicable 
disease,  by  advice  and  by  furnishing  those  specific  preventive  mea- 
sures discovered  by  Jenner,  Pasteur,  Schick,  Dick,  and  other  discover- 
ies and  developments  based  on  the  work  of  Bering,  Ebert,  Reed,  Gor- 
gas.  Carter,  Stokes,  Bauer  and  others. 

In  harmony  with  the  above,  our  Honorable  Board  of  Health  ruled 
that  the  State  Health  Officer  be  instructed  to  intensify  the  prosecution 
of  health  activities,  mentioning  among  other  matters,  a  more  vigorous 
enforcement  of  the  Drug  Store  Inspection  Law,  Chapter  1  1859 — (No. 
54)  Laws  of  1927,  whereby  anyone  operating  a  Drug  Store,  or  any 
store  which  by  virtue  of  its  advertising  or  display  has  the  appearance 
of  being  such,  shall  pay  an  annual  fee  of  $10,00  and  shall  at  all  times 
have  a  registered  pharmacist,  a  person  qualified  to  compound  such  pre- 
scriptions as  the  physician  may  find  necessary  to  prescribe  for  his  pa- 


FLORIDA    STATE   BOARD    OF   HEALTH 


ADMINISTRATION 

tients.     Those  who  refuse  to  comply  will  be  prosecuted  for  violating 
a  state  law. 

In  the  future,  after  due  notice  has  been  served,  curative  biologies 
will  only  be  given  free  of  charge  to  those  who,  by  virtue  of  circum- 
stances, are  unable  to  pay,  but  it  will  be  required  of  them  that  they 
sign  a  certificate  attesting  such  to  be  a  fact.  This  is  absolutely  neces- 
sary in  that  the  Auditor  of  the  State  Board  of  Health  must  render  an 
account  to  the  State  Comptroller  of  all  monies  spent. 

All  prophylactic  remedies,  such  as  typhoid  vaccine,  toxin  anti- 
toxin, smallpox  vaccine  and  carbon  tetrachloride  for  hookworm  treat- 
ment will  be  provided  free  of  cost  to  all  citizens  of  the  state  as  has 
been  the  custom  in  the  past. 

The  Board  also  took  measures  to  alleviate  the  malaria  situation 
which  has  prevailed  along  the  Gulf  coast,  by  providing  means  to  carry 
on  a  series  of  screening  demonstrations  in  each  of  the  counties  most 
seriously  affected.  This  will  be  done  in  the  spring  as  soon  as  the  mos- 
quito activity  starts  -with  the  onset  of ...  the  warm  weather.  The  Engi- 
neering Department  will  also  make  dusting  experiments  and  demon- 
strations for  Anopheles  destruction,  in  addition  to  which  the  Bureau 
of  Communicable  Diseases  will  carry  on  extensive  experiments  with 
quinine  control. 

For  the  rural  farming  communities  in  the  north  and  western 
portion  of  the  state,  it  is  felt  that  the  farming  can  be  made  vastly 
more  profitable  by  the  inauguration  of  an  active  malaria  and  hook- 
worm campaign.  For  the  hookworm  sufferers  there  will  be  great  re- 
lief if  at  each  home  they  will  provide  themselves  with  the  type  of 
privy  recommended  by  the  State  Board  of  Health. 

How  many,  know  that  one  female  hookworm  produces  as  many 
as  9000  eggs  in  24  hours;  that  these  eggs  under  normally  favor- 
able conditions  will  develop  into  infective  larvae  within  120  hours; 
and  that  anyone  who  walks  in  sand  or  ground  infested  with  these  will 
become  infected  by  such  larvae?  Do  you  realize  that  the  establish- 
ment and  use  of  a  proper  privy  at  your  farm  will  mean  increasing  the 
labor  efficiency  ofyour  children  farm  labor  from  35  %  to  75  %  or  even 
more,  besides  maxing  life  bright  and  h^ppy? 

The  State  Board  of  Health  approved  the  negotiations  of  the  State 
Health  Officer  with  the  Rockefeller  Foundation  by  which  the  services 
of  a  highly  trained  physician  was  secured  as  Director  of  the  Bureau 
of  Diagnostic  Laboratories.  For  this  position  Dr.  Paul  Eaton  was 
recommended  by  Dr.  W.  H.  Frost  of  the  Johns  Hopkins  School  of 
Hygiene  and  by  the  Assistant  Surgeon  General  of  the  U.  S.  Public 
Health  Service.  This  appointment  will  mean  a  great  deal  to  the 
medical  profession  as  well  as  the  administration  besides  being  a  great 
relief  to   the  present  overworked   laboratory  staff  at  headquarters. 

In  the  interest  of  further  advancing  the  Child  Health  activities, 
the  State  Health  Officer  was  authorized  to  secure  a  pediatrician  with 
Public  Health  experience,  preferably  one  recommended  by  the 
American  Child  Health  Association.  Lucille  Spires  Blachly,  M.  D., 
has  been  selected   for  this   position   and   comes   highly   recommended 


FLORIDA  STATE  BOARD  OF  HEALTH 


ADMINISTRATION 

by  the  General  Executive  of  this  Association,  and  the  Director  Divi- 
sion of  Medical  Service.  Dr.  Blachly  was  director  of  the  Bureau  of 
Maternity  and  Infancy  of  the  State  Department  of  Health,  Oklahoma 
City,  Oklahoma  and  Dr.  Wilkes  has  the  following  to  say  of  her  work: 
"Dr.  Blachly  has  done  excellent  work  in  Oklahoma  and  has  the  full 
cooperation  and  backing  of  the  physicians  of  that  State.  She  is  capa- 
ble and  experienced  and  Dr.  Crumbine  and  1  are  glad  to  recommend 
her."  * 

The  final  action  of  major  importance  in  this  meeting  was  that 
of  placing  tularemia  and  undulant  fever  on  the  list  of  reportable 
diseases,  as  there  appears  to  have  been  a  rather  serious  increase  in 
recent  years.  The  State  Health  Officer  is  therefore,  asking  the  co- 
operation of  all  physicians  in  gathering  information  regarding  preva- 
lent^ in  Florida.  It  is  asked  that  they  report  all  suspected  cases 
whether  confirmed  by  laboratory  diagnosis  or  not.  The  laboratories 
wiH  be  ready  to  assist  in  the  diagnosis  by  making  the  necessary  serolo- 
gical tests. 


CHILD    HYGIENE    AND    PUBLIC   HEALTH   NURSING 
Mrs.    Laurie   Jean   Reid,   R.    N.,   Director 

CONCLUSIONS 

If  we  are  to  judge  from  our  observations  of  the  many  failures 
in  all  lines  of  endeavor,  we  would  be  led  to  believe  that  the  state- 
ment that  "Few  people  really  think"  is  true.  Some  failures  are  un- 
avoidable but  not  the  majority.  It  would  appear  that  any  right- 
minded  person  with  good  mental  balance  would  not  only  carefully 
plan  for  the  beginning  of  a  piece  of  work  but  would  go  further  and 
try  to  envision  the  goal  to  be  attained  and  proper  methods  of  attain- 
ment. An  old  maxim  says  that  "anything  worth  doing  is  worth  doing 
well,"  and  certainly  a  task  not  carried  to  some  definite  conclusion 
would  appear  to  be  a  waste  of  time  and  effort.  More  than  that, 
the  fact  that  results  had  not  been  obtained  ■would  tend  to  engender 
a  lack  of  confidence  in  the  minds  of  observers. 

In  the  field  of  public  health,  the  nurse  has  a  very  definite  place 
and  given  good  training,  there  should  be  valuable  accomplishment  to 
off-set  the  expenditure  for  her  work.  Too  often  the  nurse,  knowing 
the  attitude  of  the  people  with  whom  she  is  to  work,  against  her  own 
better  judgment,  will  enlarge  her  program  until  she  is  spreading  her- 
self so  thinly  over  her  district  that  she  is  not  leaving  a  distinct  mark 
in  any  one  place,  and   this  is  poor  policy. 

Before  undertaking  a  piece  of  work  of  whatever  nature,  the 
nurse  in  rural  work  should  make  a  plan  which  would  cover  the  pro- 
gram from  the  first  notice  sent  to  the  newspaper  on  her  arrival  to  her 
final  arrangement  with  some  responsible  local  person  to  carry  on 
when  the  nurse  leaves  the  county  or  completes  her  work  in  the  com- 
munity in  question. 

With  this  thought  in  mind,  the  "advance  agent"  work  should  be 
very  thoroughly  done  and  should  be  arranged  in  proper  sequence  as 


FLORIDA   STATE   BOARD    OF    HEALTH 


CHILD   HYGIENE   AND  PUBLIC  HEALTH  NURSING 

follows:  First,  the  nurse  should  have  all  possible  knowledge  of  the 
territory  to  be  covered;  second,  an  advance  notice  of  the  nurse's 
presence  and  mission  in  the  community  with  the  approximate  time  to 
be  given  to  the  piece  of  work;  third,  professional  visits  to  the  local 
health  authorities  and  physicians;  fourth,  conferences  with  all  key 
people,  individually  or  collectively  as  indicated  with  whom  should  be 
discussed  the  work  in  hand  and  their  assistance  and  cooperation  asked: 
fifth,  contact  should  be  made  with  the  various  organizations,  including 
women's  clubs,  men's  luncheon  clubs  which  have  become  so  great 
a  factor  in  providing  the  wherewithal  for  corrective  work,  and  churches, 
where  the  missionary  society  and  other  church  organizations  are  more 
each  year  turning  their  efforts  along  health  lines.  In  order  to  carry 
her  work  to  a  satisfactory  conclusion,  theft  is  usually  the  necessity  for 
the  expenditure  of  money  for  corrections  and  remedial  work  of  various 
kinds  and  since  this  always  a  local  problem,  the  nurse  should  see  to 
tt  that  the  public  is  well  informed  as  to  the  probabilities  and  the 
apparent  needs  in  order  that  the  work  begun  may  be  effectively  com- 
pleted. 

The  nurse  who  is  alert  and  anxious  to  do  a  good  piece  of  work 
will  very  carefully  and  riainstakingly  do  her  advance  agent  work.  If 
school  work  is  to  be  included  in  her  program,  preliminary  visits  should 
be  made  to  the  schools  when  the  teachers  should  be  interviewed  and 
at  least  the  introduction  of  the  nurse  made  to  the  children  with  a 
brief  explanation  of  what  it  is  all  about.  All  this  will  serve  to  place 
the  nurse  in  the  community. 

In  conducting  baby  and  pre-school  conferences,  the  mother  is 
usually  with  her  children,  so  that  the  nurse,  if  there  is  sufficient  time, 
can  give  the  necessary  instruction.  However,  conditions  in  the  home 
are  so  often  responsible  for  the  physical  disabilities  of  the  members 
of  the  family  that  a  visit  to  the  home  would  usually  be  indicated  where 
there  is  sufficient  time.  The  nurse  should  have  all  the  information 
necessary  regarding  possible  expenditures  so  that  they  are  available 
instantly  when  asked  for  and  should  have  the  set-up  for  clinics  or  plans 
for  corrective  work  already  on  paper  for  the_a^se  of  those  who  may 
want  the  information.  If  the  nurse  can  sit  dowtaand  talk  with  the 
parents  explaining  patiently  and  in  sufficient  detaiTin  understandable 
English  just  what  the  various  defects  mean  and  just  why  they  should 
be  given  special  attention,  she  is  very  much  more  apt  to  have  their 
cooperation. 

We  should  always  stress  positive  health  and  everything  we  do 
should  simply  be  another  thing  to  help  bring  about  this  condition. 
Advance  agent  work  does  take  time  but  it  is  time  well  spent  and  if 
properly  done  time  is  saved,  in  that  the  nurse  carries  her  community 
with  her  through  her  piece  of  work.  True  it  is  that  many  forget  or 
can  not  be  interested,  but  the  majority  can  be  reached  if  properly 
approached  and  there  is  no  better  way  of  gaining  interest  than  by 
giving  people  something  to  do.  Let  them  know  that  you  depend  upon 
them  to  help  you  and  let  them  also  know  what  it  will  mean  in  accom- 
plishment if  they  do.  Try  to  arouse  civic  pride  and  that  also  will 
have  its  value. 


■\ 


FLORIDA  STATE  BOARD  OF  HEALTH 


CHILD    HYGIENE    AND    PUBLIC   HEALTH   NURSING 

Every  day  the  papers  and  magazines  tell  us  of  some  piece  of 
work  begun,  usually  with  the  ringing  of  bells  and  the  waving  of  ban- 
ners, that  has  fallen  through.  The  public  health  nurse  does  hot  do 
her  work  to  the  waving  of  banners  and  the  blare  of  trumpets  for  the 
most  part.  Particularly  in  Florida  where  so  much  of  the  population 
Is  rural,  her  work  is  accomplished  quietly  and  not  very  well  understood  , 
except  by  those  concerned.  It  takes  courage,  as  well  as  good  train- 
ing, a  world  of  common  sense,  and  a  fund  of  humor  to  plan  a  piece 
of  work  in  the  rural  areas  where  the  counties  are  sparsely  settled  and 
the  country  roads  are  lonely  and  none  too  good,  but  Lo  my  mind,  the 
rural  field  is  the  most  fertile  field  for  public  health  nurses  where  much 
can  be  accomplished  if  properly  and  painstakingly  planned  and  the 
plan   carried   through   to  a  definite  conclusion. 


BUREAU    OF   ENGINEERING 

Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

BUSINESS   IS    GOOD II 

When  the  world  of  finance  shows  unmistakable  signs  of  acting 
like  a  plane  in  "bumpy"  air,  every  activity  of  man  is  influenced  by 
the  reaction.  Even  health  departments  react  to  financial  barometers. 
But  there  is  one  thing  that  can  be  said  never  to  fluctuate  and  that  is 
the  amount  of  work  to  be  done.  There  is  always  more  to  be  done  than 
there  is  time  for!  Health  departments  are  usually  subject  to  cuts  in 
appropriations  when  economy  waves  strike  our  governmental  fathers 
— a  foolish  practice,  we  believe,  but  nevertheless  an  actual  one.  With 
the  cuts  and  slashes  in  municipal  and  county  health  programs,  comes 
more  and  more  work  on  our  state  staff.  The  problems  are  put  up  to  us; 
we  must  meet  them.  So  it  is  we  tighten  our  belts,  renew  our  search 
for  newer  and  quicker  ways  of  doing  things,  and  go  after,  the  work. 

One  inspector  on  our  staff  once  remarked  he  thought  he  had  his 
District  about  worked  out  but  that  was  three  years  ago  and  he  is  stead- 
ily doing  more  and  more  work  and  finding  new  things  to  be  done. 
Time  brings  new  problems  for  in  the  last  two  years  we  have  had  a 
very  serious  increase  injnalaria  in  this  state  and  the  problem  of  putting 
over  a  screening  program,  for  our  scattered  rural  dwellings,  presents 
itself.  Also  comes  a  renewal  of  the  city  anti-mosquito  programs  for 
in  some  localities,  these  programs  have  lapsed  during  the  past  few 
years  of  low  financial  barometer. 

And,  speaking  of  low  barometers,  we  can  well  pattern  after 
the  seacoast  towns  and  people.  When  the  barometer  goes  down, 
then  the  people  know  trouble  is  coming  and  prepare  for  it!  In  south 
Florida,  a  serious  drop  in  the  barometer  means  that  storm  guards  for 
windows  and  doors  must  be  put  up,  that  vital  machinery  such  as 
electric  driven  water  pumps  must  be  protected,  that  a  reserve  supply 
of  liquid  fuel  and  even  candles  should  be  on  hand  for  trouble.  Re- 
serve food  supplies  are  laid  in,  etc.     If  the  mercury  starts  sliding  down 


FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU    OF    ENGINEERING 

to  the  bottom  of  our  thermometers,  then  our  growers  are  on  the  alert 
and,  as  critical  temperatures  are  reached,  smudges  are  started  and 
perhaps  the  irrigation  pumps  are  put  to  work  to  flood  tender  crops. 
But  in  health  work,  the  reaction  is  usually  different.  In  times  of 
low  finances,  the  people  are  loath  to  put  the  necessary  health  machin- 
ery into  operation.  They  prefer  to  gamble  and.  sad  but  true,  very, 
very  often  lose.  We  are  aware  of  a  wet  summer  and  fall  season 
following  an  extensive  drought.  Malaria  should  be  on  the  increase. 
A  warning  is  issued  and  people  are  told  to  prepare,  but  they  do 
not  do  it.  Screens  are  expensive  and  besides,  they  keep  out  the  air 
(so  the  country  folks  tell  us)  but  they  do  not  stop  to  figure  that 
while  a  mosquito-proof  house  might  cost  $25,  they  spend  $40  a  year 
on  anti-mosquito  sprays,  dozen  or  so  bottles  of  chill  tonic,  and  per- 
haps a  doctor's  visit  and  prescription  filling.  Partial  payments  and 
small  outlays  spread  over  months  is  the  business  motto  of  today  and 
the  people  have  fallen  into  this  habit.  Unfortunately,  sanitary  im- 
provements such  as  mosquito  proofing  a  house,  building  a  sanitary 
privy  and  installing  plumbing  can  seldom  be  done  on  a  partial  pay- 
ment plan.  If  it  could,  we  would  get  more  work  done.  Finding  a 
way  to  do  this  in  Florida  is  one  of  our  jobs. 

Business  is  good.  It  is  too  good  for  our  small  staff,  we  have  to 
spread  our  efforts  too  thin.  The  problems  are  manifold  and  results 
meagre  in  proportion  to  what  we  could  get  with  more  personnel. 
And  the  rewards — well,  what  are  the  rewards  of  a  health  worker 
other  than  the  knowledge  that  he  has  perhaps  done  his  bit  in  making 
this  world  of  ours  a  little  better  place  to  live  in  and  a  little  more  com- 
fortable for  others,  that  he  has  served  well  for.  truly,  happiness  is 
in  serving  and  not  in   being  served. 

And  so  the  New  Year  opens  before  us — new  problems,  old 
problems,  new  trials,  old  tribulations,  new  joys,  new  sorrows,  new 
co-workers,  old  standbys,  new  officials  to  convince,  old  ones  to  spur 
on.  May  the  New  Year  provide  plenty  of  work  for  you  and  the  op- 
portunity for  you  to  serve  others  by  doing  it,  for  therein  is  the  true 
happiness  and   understanding. 


WHY   WE  EAT   DESSERT   AT  END  OF  MEAL 
Have  you  ever  pondered   the  question  of  why  sweet  things  are 
eaten  at  the  end  of  a  meal? 

Dr.  B.  C.  H.  Harvey,  who  is  writing  a  series  of  articles  on  ana- 
tomy in  Hygeia.  the  health  magazine  published  by  the  American 
Medical  Association,  gives  an  explanation. 

The  part  of  a  meal  first  eaten  is  spread  over  the  surface  of  the 
mucous  membrane  of  the  stomach  and  becomes  saturated  with  acid 
and  pepsin.  The  part  last  eaten  (dessert)  remains  in  the  center, 
unaffected  by  the  acid.  In  this  central  part,  which  remains  alkaline, 
the,  ptyalin  of  the  saliva  continues  to  work  for  perhaps  an  hour.  This 
ferment  works  on  carbohydrates,  leading  water  into  starch  molecules 
and  so  making  sugars  of  them.  Fats  and  carbohydrates  are  not 
digested  in  acid;  this  is  the  reason  we  have  found  it  better  to  eat 
meat  and  other  proteins  at  the  beginning  of  a  dinner  and  fats  and 
carbohydrates  (cream  and  sweet  things)   as  dessert. 


FLORIDA    STATE   BOARD    OF   HEALTH 


BUREAU   OF    DIAGNOSTIC    LABORATORIES 
Pearl  Griffith,  B.  E.,  Acting  Director 

SUMMARY    OF   WORK   DONE    IN    THE    LABORATORIES   OF 

THE   STATE   BOARD   OF   HEALTH 

DURING   THE   MONTH   OF  NOVEMBER,    1929 

Jacksonville     Tampa      Pcnsacota     Miami      TaiLahaanee     Total 

Animal  Parasites  ., 1725  934  370  87  27  3143 

Diphtheria    1267  485  11  804  9  2576 

Typhoid  457  142  40  109  15  763 

Malaria  423  189  37  34  123  806 

Rabies    25  3  1  29 

Tuberculosis    163  65  7  37  6  278 

Gonorrhea    368  206  26  146  19  765 

Kahn    3268  993  524  4785 

Water:  Count  43  190  3  236 

Water:  Colon  - 254  3  257 

Milk:  Bacterial  Exam 27  124  33  243  12  439 

Milk:  Chemical  Exam 29  124  33  123  12  321 

Miscellaneous    192  44  14  189  19  458 

7944     3352        571      2741        248    14856 
Specimen  Containers  Distributed „ » 7964 

BIOLOGICAL  PRODUCTS  DISTRIBUTED 

Diphtheria  Antitoxin 10,000  units               303  Packages 

5.000  units                 75  Packages 

Toxin  Antitoxin 15,382  C   C. 

Schick 2,250  Tests 

Tetanus  Antitoxin 20,000  units                  47  Packages 

10,000  units                 28  Pdfckages 

1,500  units               813  Packages 

Anaerobic  Antitoxin 1 00's  3  Packages 

1 0's  12  Packages 

Typhoid  Vaccine  1,216  Treatments 

Vaccine  Virus 3,470  Capillaries 

Antirabic  Virus 3  1  Treatments 

An  timeningococcus  Sernm „.  29  Cylinders 

Carbon  Tetrachloride 4,514  Capsules-* 

THE  FIRST  TWENTY  YEAR  EMPLOYEE   OF  THE 

STATE  BOARD  OF  HEALTH   SINCE  THE 

LATE    DR.  JOSEPH  Y.  PORTER 

Henry  P.  Brown  became  an  employee  of  the  State  Board  of 
Health  of  Florida  on  December  1 5,  1 909  and  enjoys  the  distinction 
of  being  the  first  to  claim  twenty  years  of  unbroken  service.  His 
faithful,  conscientious,  uncomplaining  conduct  has  endeared  him  to 
the  Staff.  An  appropriate  medal  is  being  designed  for  presentation 
to  Mr.   Brown  as  a  token  of  esteem  and  recognition  of  his  worth. 


K> FLORIDA   STATE   BOARD   OF  HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

SYNTERESIS 

If  "an  ounce  of  prevention  is  better  than  a  pound  of  cure"  and  "a 
stitch  in  time  saves  nine."  then  how  much  better  is  it  to  take  three  small 
preventive  shots  than  to  contract  diphtheria  or  typhoid;  how  much  bet- 
ter is  it  to  have  one  vaccination  to  prevent  smallpox  than  to  have 
9,000  pocks  and  perhaps  as  many  scars. 

Synteresis,  a  word  seldom  used,  means  the  same  as  prophylaxis 
or  preventive  treatment.  The  economic  soundness  of  the  idea  is  es- 
tablished. Practitioners  of  medicine  are  turning  their  attention  more 
and  more  to  preventive  medicine.  The  professors  of  the  Harvard 
Medical  School  have  written  a  book,  the  purpose  of  which  is  to  help 
other  teachers  in  bringing  to  medical  students  a  full  realization  of  their 
responsibilities — their  opportunities  to  serve  in  a  larger  way  than  did 
the  doctors  of  yesterday.  This  book  deals  in  teaching  preventive 
medicine  as  it  relates  to  each  of  the  specialties.  Its  twenty  chapters, 
cover  twenty  subjects  taught  in  medical  college  beginning  with  anato- 
my and  physiology  and  ending  with  surgery  and  industrial  hygiene. 

There  is  no  field  of  medicine,  no  branch  or  specialty  in  which 
synteresis  or  preventive  treatment  is  not  applicable.  # 

For  blindness  of  the  newborn  and  others;  for  rheumatism,  verereal 
diseases,  ulcer  of  the  stomach;  for  all  the  contagious  and  infectious 
diseases,  venereal  infections^  tuberculosis  and  the  rest;  for  diseases  of 
the  skin,  the  kidneys,  the  heart  and  blood  vessels  and  for  high  blood 
pressure;  for  mental  derangements;  for  the  accidents  to  mother  and 
infant  in  childbirth,  an  ounce  of  prevention  is  better  than  a  pound  of 
cure. 

For  deformities,  cancer  and  a  long  list  of  major  and  minor  sur- 
gical conditions,  a  stitch  in  time  will  qften  save  funeral  expenses. 

See  your  doctor  early — long  before  you  get  too  sick  to  go". 

HEALTHM0BILE 

During  November,  Mr.  W.  Y.  Randle,  operator  of  the  State 
Board  of  Health  motion  picture  outfit  gave  32  showings  in  Indian  River. 
St.  Lucie  and  Mardn  Counties,  and  at  the  Marion  County  Fair.  The 
total  attendance  was  4,023. 

We  want  the  greatest  possible  number  of  people  to  profit  by  see- 
ing the  health  movies.  Besides  being  instructive  they  are  entertaining 
and  full  of  human  interest. 

The  cooperation  of  local  health  workers,  school  authorities, 
teachers  and  others  so  essential  to  the  success  of  this  work,  has  been 
greatly  appreciated. 

Dating  must  be  made  well  in  advance  so  that  the  itinerary  can 
be  planned,  needless  travel  avoided  and  the  most  possible  good  accom- 
plished. 


FLORIDA  STATE  BOARD  OF  HEALTH H 


BUREAU  OF  COMMUNICABLE  DISEASES 

Pupils  Appreciative 

From  the  Vero  Beach  and  Wabasso  school  pupils  come  fourteen 
nicely  written  letters  expressing  pleasure  and  emphasizing  the  particular 
lesson  each  had  received  from  seeing  the  health  pictures.  These  let- 
ters show  that  the  writers  had  caught  the  ideas  the  pictures  were  in- 
tended to  convey.  They  were  well  written  and  greatly  enjoyed.  Let 
us  have  more.  They  help  those  who  write  as  well  as  those  who  re- 
ceive them. 

A  HINT  ON  MALARIA 

Dr.  David  Rose  of  Sebastian  who  has  served  the  people  of  that 
section  for  over  20  years  states  that  from  I  908  to  1  9  I  8  he  found  ma- 
laria quite  prevalent  in  an  area  twenty  miles  long  from  north  to  south 
and  four  miles  wide  from  the  coast  back  to  the  Sebastian  River.  There 
were  about  one  thousand  people  in  this  area  and  they  had  malaria  the 
year  round.  For  a  time  in  one  community  every  family  had  one  or 
more  members  with  "chills  and  fever."  He  preached  to  them  inces- 
santly about  the  use  of  screens  and  nets  until  they  adopted  his  sug- 
gestions and  malaria  practically  disappeared.  Being  a  modest  man 
the  doctor  does  not  boast  but  his  teachings  were  probably  worth  more 
to  those  people  than  any  of  them  could  realize.  One  might  infer  that 
other  doctors  and  other  communities  could  profit  by  using  screens 
and  nets.  Malaria  causes  poverty.  Malaria  can  be  prevented.  Screen- 
ing is  one  way  to  do  it. 

NOTICE  TO  DOCTORS 

Undulant  (Malta)  fever  and  Tularemia  have  been  placed  on  the 
list  of  reportable  diseases  by  official  action  of  the  State  Board  of  Health. 

The  reporting  of  these  and  the  other  reportable  diseases  is  a  duty 
you  owe  to  your  community. 

VIRULENCE  TEST 

Arrangement  has  been  made  with  the  Director  of  Laboratories 
to  make  a  virulence  test  on  diphtheria  organisms  found  in  cultures 
taken  for  the  detection  of  carriers.  Thus  we  hope  to  avoid  needless 
inconvenience  to  doctors,  health  officers  and  carriers  of  non-virulent 
organisms. 

TRAFFIC  IN  GERMS 

HOW   DISEASES   ARE   SPREAD, 

AND    THE   GERM    MARKET 

The  manner  in  which  disease  is  transmitted  was,  until  recent  years 
shrowded  in  dark  mystery.  With  the  aid  of  the  compound  microscope 
scientists  have  pried  into  the  secrets  of  nature  and  into  the  private  lives 


12  FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU  OF  COMMUNICABLE  DISEASES 


of  microscopic  plants  and  animals.  We  know  how  minute  and  pro- 
lific the  disease  producers  are  and  how,  by  virtue  of  overwhelming 
numbers  and  countless  opportunities  to  ride,  they  get  about  so  readily 
though  they  have  neither  legs  nor  wings. 

We  have  ceased  to  wonder  how  disease  is  spread.  We  wonder 
how  anyone  can  escape.  Unconsciously,  carelessly,  sometimes  indif- 
ferently or  even  viciously  mankind  maintains  a  brisk  and  continuous 
traffic  in  germs.  Perhaps  more  than  any  other  of  the  higher  animals 
the  individuals  of  the  genus  homo  swap  microbes.  In  fact  the  give 
and  take  system  of  bacterial  traffic  would  seem  to  be  developed  to  a 
degree  of  efficiency  excelled  by  no  other. 

For  many  diseases  the  infection  is  present  in  the  nose  and  throat 
secretions  of  patients  and  carriers.  Such  persons,  if  their  hands  are 
freshly  soiled  with  these  secretions,  may  deposit  on  everything  they 
touch  a  sufficient  number  of  germs  to  infect  many  who  come  in  con- 
tact with  those  soiled  objects. 

The  idea'of  a  public  drinking  cup  or  a  family  tooth  brush  is  too  re- 
volting to  discuss.  The  danger  of  kissing  has  been  made  a  joke.  The 
friendly  handshake,  a  custom  established  by  long  usage,  may  prove 
disastrous  if  the  hands  are  not  free  of  deadly  germs.  The  pencil,  era- 
ser, telephone  transmitter,  anything  in  fact,  that  touches  or  goes  into 
the  mouth  may  prove  an  agent  for  the  transmission  of  disease.  The 
door  knob,  stair  rail,  chair  arm,  street  car  strap,  even  money  may  have 
been  soiled  with  the  hand  of  a  careless  person. 

What  To  Do  About   It 

No  one  need  be  too  finicky  about  contacts  with  all  these  ob- 
jects but  one  can  well  afford  to  be  a  little  finicky  at  least  about  eating, 
placing  the  hands  to  the  mouth  or  eyes  and  moistening  the  fingers 
with  the  tongue  if  the  hands  have  not  been  recently  and  thoroughly 
cleansed  with  soap  and  ■water  and  dried  with  a  clean  towel.  Cover  the 
nose  and  mouth  when  you  cough  or  sneeze.  Avoid  persons  who  neg- 
lect this  precaution. 

Then  danger  of  "catching"  common  colds,  influenza,  diphtheria 
and  a  number  of  other  more  or  less  serious  infectious  diseases  may  be 
minimized  by  a  little  care  and  cleanliness. 


DOCTORS  PLEASE  NOTE  » 

In  the  future  the  State  Board  of  Health  is  considering  free  antira- 
bic  treatments,  in  which  case  no  treatment  will  be  sent  unless  the  name, 
age  and  sex  of  patient  is  given  by  the  attending  physician  when  treat- 
ment is  ordered.     For  more  details  see  next  issue  of  Health  Notes. 


FLORIDA   STATE   BOARD   OF   HEALTH !3_ 

BUREAU    OF    VITAL    STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

NEW   CERTIFICATE    FORMS 

The  new  United  States  standard  certificates  of 
births  and  deaths  are  now  in  effect.  Beginning  with 
this  month,  the  new  forms  should  be  used  when 
reporting  births  and  deaths  to  the  State  Board  of 
Health.  Please  do  not  use  any  of  the  old,  obsolete 
forms  in  the  future.  Every  local  registrar  has  been 
generously  supplied  with  the  new  forms  so  that 
there  is,  therefore,  no  reason  for  using  the  old  ones. 
To  keep  the  Florida  Vital  Statistics  records  up  to  standard,  it  is  neces- 
sary to  use  the  very  latest  approved  certificate  forms. 

These  new  United  States  standard  forms  are  the  ones  required 
by  law  in  this  state.  They  are  also  the  forms  used  in  practically  every 
state  in  the  Union  at  the  present  time.  The  centralization  of  birth 
and  death  records  has  spread  very  rapidly  in  recent  years  and  the 
United  States  Registration  Area  for  Births  and  Deaths  now  includes 
all  but  three  states.  These  three  states  are  working  very  hard  to  bring 
their  birth  and  death  registration-  up  to  standard  and  as  soon  as  New 
Mexico,  South  Dakota  and  Texas  are  standardized,  it  will  no  longer 
be  called  the  United  States  Registration  Area  for  Births  or  Deaths,  but 
"United  States  Birth  and  Death  Registration". 

FT.  PIERCE  DOCTOR  CONGRATULATED 

Very  often  the  attending  physician  has  difficulty  in  securing  the 
history  necessary  to  properly  fill  out  a  birth  certificate.  In  some  cases, 
the  doctor  is  able  to  gather  the  history  of  the  father  and  mother  dur- 
ing a  visit  before  or  after  confinement.  However,  in  many  instances, 
it  is  inopportune  to  talk  about  a  birth  certificate  and,  therefore,  the 
busy  doctor  gets  away  without  certain  necessary  and  important  in- 
formation as  to  the  family  history  which  should  appear  on  the  original 
record  which  is  to  bear  his  signature. 

Dr.  L.  L.  Whiddon  of  Ft.  Pierce,  Florida,  has  installed  a  very 
clever  system  as  an  aid  in  securing  family  history.  Dr.  Whiddon  has 
had  postal  cards  printed,  allowing  space  for  the  date  of  birth,  baby's 
name,  sex,  father's  name  and  age,  mother's  name  before  marriage, 
etc.  At  the  bottom  of  the  card,  a  notice  to  the  parents  appears,  re- 
questing the  card  to  be  mailed  promptly.  This  card  is  addressed  to 
Dr.  L.  L.  Whiddon  of  Ft.  Piprce  and  it  also  includes  the  postage. 
In  this  way.  Dr.  Whiddon  has  been  very  successful  in  securing  the 
necessary  information   for  preparing  very  excellent  birth  certificates. 

The  parents  of  a  child  appreciate  the  diligence  of  their  family 
physician  in  placing  on  file  the  birth  certificate  which  is  the  evidence 
provided  by  law  of  their  baby's  citizenship.  Many  times  after  the 
faithful  physician  has  passed  on  to  his  reward,  the  young  man  or  the 
young  woman  secures  a  certified  copy  of  this  birth  certificate,  bearing 
the  signature  of  the  good,  old  family  physician  and  is  able  to  secure 
employment,  passports  and  otherwise  prove  American  citizenship, 
inheritances,  etc. 


H FLORIDA   STATE   BOARD    OF   HEALTH 

BUREAU  OF  VITAL  STATISTICS 

Hosts  of  faithful  doctors  in  Florida  look  after  the  interests  of 
parents  and  children  under  their  care  who  do  not  receive  special 
mention  publicly.  However,  since  Dr.  Whid don's  unique  system  has 
just  come  to  the  attention  of  the  writer,  it  seems  appropriate  to  pass 
the  information   on  for  the  benefit  of  those  who  may  be  interested. 

The  end  of  1929  has  been  reached  and  the  pages  of  1930  are 
now  open.  It  is  hoped  that  the  1929  records  for  births  will  be  com- 
plete. Every  physician  is,  therefore,  requested  and  urged  to  check 
over  his  personal  accounts  to  see  that  each  birth  he  attended  has  been 
REPORTED. 


The  following  tables  indicate  the  number  of  deaths  from  certain 
diseases  by  months,  for  1929  as  compared  with  the  previous  year. 
(Provisional  figures.) 

^_^y  TYPHOID    DEATHS 

Year Jan.       Feb.     Mar.     Apr.       May     June     July  -  Aug-     Sept.     Oct.  Total 

192  9 2        4        5      1  1         8      11       13        6        4        5  69 

1928 7        2        9        4      18      12      19      14        7      14  106 

MALARIA    DEATHS 

Year                                   Jan*       Feb,      Mar,      Apr*       May      June      July       Aug,      Sept,      OcL  Total 

F929 24        7      L5"- T4~3G~36— 60     57     66     53  362 

1928 9       9     13      10     24      16     26     36     39     84  266 

DIPHTHERIA    DEATHS 

Year Jan.       Feb.      Mar.     Apr.       May     June     July      Aug.      Sept.      Oct.  Total 

1929 8        6       3        3        3        1         1        8        8       5  46 

1928 13744526847  60 


The  59th  Annual  Meeting  of  the  American  Public  Health  As- 
sociation will  be  held  in  Fort  Worth,  Texas,  during  the  week  of  Octo- 
ber 27,    1930,   with  the  Hotel  Texas  as  headquarters. 

The  Annual  Meetings  of  this  oldest  and  strongest  of  public 
health  organizations  bring  together  for  a  week  of  scientific  discussion, 
all  of  the  public  health  leaders  of  the  continent.  It  is  always  the 
most  important  health  convention  of  the  year.  Health  officers,  nurses, 
dieticians,  sanitary  engineers,  child  and  industrial  hygienists — all  of 
the  specialists  that  make  up  the  public  health  profession — meet  to 
consider  their  common  problems.  Each  of  the  ten  Sections  of  the 
Association — Health  Officers,  Laboratory,  Vital  Statistics,  Public 
Engineering,  Public  Health  Nursing.  Public  Health  Education,  Food, 
Drugs  and  Nutrition,  Industrial  Hygiene,  Child  Hygiene  and  Epidem- 
iology— arrange  an  individual  program  and  there  are  a  number  of 
General  Sessions  to  which  the  public  is  invited. 

Detailed  programs  of  the  Fort  Worth  meetings  will  be  announced 
in  the  official  publication  of  the  Association  —  THE  AMERICAN 
JOURNAL  OF  PUBLIC  HEALTH  AND  THE  NATIONS  HEALTH. 

Further  information  may  be  obtained  from   the  Executive  Secretary, 
Mr.  Homer  N.  Calver,   370  Seventh  Avenue,  New  York,   N.  Y. 


« 


FLORIDA    STATE   BOARD   OF   HEALTH 


!5 


BUREAU   OF   VITAL   STATISTICS 

^PROVISIONAL    MORTALITY    FOR    OCTOBER,    1929 


IntVl 
List  No. 
(1920) 


FLORIDA 


Number  of   deaths 


1-205 

1 

5 

6 

7 

8 

9 

10 

1  I 

22 

23 

24 

31-37 

43-49 

54 

57 

70-86 

74 

87-96 

87-96 

97-107 

100-101 

108-127 

I  13 

128-142 

128-129 

143-150 


ALL  CAUSES .. 
Typhoid ... 

Malaria 

Smallpox 

Measlea 

Scarlet  fever- 


Whooping  cough — - 

Diphtheria... . -  -  -■-- — ~-. . 

Influenza _ _. 

Acute  anterior  poliomyelitis 
Lethargic  encephalitis 


Meningococcus  meningitis 
Tuberculosis — all  forms- 
Cancer all    forms.. 

Pellagra 

Diabetes    mellitua — 

Disease*  of  the  nervous  system.. 


Cerebral  hemorrhage,    apoplexy 
Diseases  of  the  circulatory  system- 
Diseases   of   the    heart _ 

Diseases  of  the  respiratory  system... 

Pn  eum  o  nia a  II    f o  rm  s.„ 

Diseases   of  the   digestive   system.. 


Diarrhea  and  enteritis   (under  2   years) 

Nonvenereal  diseases  of  the  genitourinary  system,. 

Nephritis all   forms... ; -■ 

The  puerperal  state — — _ — - ... 


INFANT  MORTALITY 

Number  of  LIVE  BIRTHS- _ 

Number  of  STILL  BIRTHS 

Number   of  DEATHS  under    I    year- 


By  cause:    (deaths  under    I    year) 

Infectious  diseases    (1-42,  exc.    II     31,   37a). 
Infectious    diseases    (1-42,    exc.    II,    31,    37a). 

GastTO -intestinal  diseases    (112,    I  13) 

Malformations  and  early  infancy  (159-163) 

Premature  birth    (1  61a) __ 

Injury  at  birth   (I  61b) 


Total 

White 

1.415 

780 

6 

4 

63 

37 

0 

0 

0 

0 

0 

0 

4 

0 

5 

4 

20 

10 

3 

0 

1 

1 

0 

0 

73 

21 

91 

71 

33 

11 

17 

10 

129 

71 

105 

58 

198 

132 

181 

119  ' 

65 

29  1 

47 

22 

112 

63 

22 

12 

175 

98 

149 

83 

24 

16 

* 

2.331 

1.532 

163 

73 

151 

67 

109 

56 

10 

5 

15 

5 

16 

8 

68 

38 

36 

16 

7 

6 

- 

635 

2 

26 

0 

0 

0 

4 

I 

10 

0 

0 

0 

52 

20 

22 

7 

58 

47 

66 

62 

36 

25 

49 

10 

77 

66 

8 


799 
90 
84 
53 

5 
10 

8 
30 
20 

I 


ALL  CAUSES,  BY  ACE 


Ages 


■I        I 


0-4 


Deaths 

J5I 
175 
56' 


30-34   | 
60-64       I  1 0 


90-94   |      10 


Ages 

~i~ 

_5-9_ 
35-39 


Deathi 

U6" 

}_20_ 
77 


65^69_ 
95-99 


101 


Ages 

~2~ 


Death; 

9 


10-14  |  1 5 
40I44_| [73" 
"70-74   1   105" 


100-     |        1 


Ages 

15-19 


Deaths 

l_    7 

50 


45-49J_H)6 
75-79  J"     73" 


Unk.   ]      10 


Ages 

Deaths 

4 

1   9 

20-24 

|   66 

50-54 

|  96 

80-84 

|  40 

Ages 
Und.  5 


25-29 


A5!59 

85^89 

Total" 


Deaths 
184 


66 


_L09_ 
33 

1415 


*  Includes   delayed  Certificates 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


CONSULT  YOUR  DOCTOR  AND  AVOID   DANGER 


©A.  P.  H.A. 


This  Issue  Exceeds   1  1,000  Copies 


fUORIDA 


AlTH  NOf 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY,    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered   as  Second   Class   Matter,  October  27,   1921 
at  the   Posloffice  at   Jacksonville,    Florida,   Under  the  Act  of   August    24,    1912 

This  Bulletin  wijl  be  sent   to  any   address  in  the  State  free  of  charge. 

Vol.  22  FEBRUARY,    1930  No.   2 


Edited    by 

STEWART  G.  THOMPSON,  D.P.H.,  Member 

American   Medical   Editors'   and    Authors'  Assn. 


SPECIAL  ARTICLES 

DOES  IT  PAY?— Eaton 

MOSQUITO    CONTROL— Fitby 

WHAT  IS  HEALTH?— McLaughlin 

THE  NEW  PUBLIC  HEALTH— Brink 

ANTIRABIC    VACCINE    FREE— Hanson 

MORTALITY    FOR    NOVEMBER— Tkompson 


HENRY  HANSON,  M.  D..  STATE  HEALTH  OFFICER 


18 


FLORIDA    STATE   BOARD    OF   HEALTH 


Chan.     H.     Mann.     Fret. 
Jacksonville 


BOARD   MEMBERS 

H.    Mason   Smith.    M.    D. 
Tampa 


Wn 


D.  Nobles.  M.D. 
Pensacola 


STATE  HEALTH  OFFICER 

Henry    H Anson,    M,     D. 


BUREAUS  AT  JACKSONVILLE 


Diagnostic    Laboratories.. 
*  Vital    Statistics- 


Communicable    Diseases. 
Engineering- 


Child  Hygiene  and  Public  Health  Nursing- 


DIRECTORS 

Paul  Eaton,  M.   D..  D,   P.   H. 
Stewart   G,    Thompson,    D.    P.    H. 
F,  A.  Brink,  M.  D. 
Ellsworth  L.    Filby.  C  -E. 
Clio   McLaughlin,   R,   N.,  Acting 


—~...    Sc  raven   Dozjer 
— —    F.   L.    Fort,   M.  D. 


Accounting- 
Crippled  Children. .. 

*530    Local    Registrars     {County    list    furnished    on    request). 

•Rcjrtst ration     Inspector , — „ —   Anna  C.  Emmons 

Drug  Store   Inspector m,-mmT,,_mr,_„m___     H.  R.  Monroe 

Drug  Store    Inspector . '. W.   A.    Mahoney 


LABORATORIES 


Jacksonville — _ 

Miami 

Pen  sa  cola — ... 
Tallahassee.. 
Tampa 


Pearl   Griffith. 
E.  R.    Powell 


B.   E. 


Janie  B.  Currie,  B.  3. 
Elizabeth  Byrd.  B.  S. 
H.    D.    Venters.    B.   S. 


MEDICAL    OFFICERS 


DrFuniak     Springs 
Jacksonville 

M  elbo  u  Tn  e 

Quincy.    ._„,- 

Tallahassee— — — - 

Ta  m  pa ......  --  -,— 


C.    W.    McDonald,    M.    D, 
B.   C.   Wilson.   M     D 

IV     A.    CinTion.    M.    D. 

A.  C  Mamblin,  M  D. 
A,  P.  Harrison.  M.  D, 
Chas.  W.  Pease,  M.  D. 


DISTRICT   SANITARY    OFFICERS 


TampA 

InrkjOTTviUe  — 
MiamL_~^. — - 

Oca  In „ 

Orlando 

Punta  Gorda. 
Tallahnssee — 


Tampa  . 


*V.  B.  Umoureui,  C  E- 
Fredt  A.   Safay 
George    B.    Reed 
C:  A*    Hollows? 
Russell    Broufihrnan 
-  Q.  A.  Renney 
.    a  N.  Hobbs 
D.  H,  0*bnra 
'Assumni    Engineer 


PUBLIC   HEALTH   NURSES 


Lake    City 
Tampa.— ^ 
Arcadia.. 


DeFuniak  Springs _™ 

Eden,   R.    F.    D.    Jensen.. 
Lake    City. 

Madison . ,,     , 

M  a  ria  una 

Ruskin- 
Starke. 


...  'Clio    McLaughlin.    R.    N, 
.'Harriet    [.  Sherman.  R.   N. 

Jule    Graves,    R.    N. 

.      Manna   Colby,   R.  N. 
.     Sarah   Ida    Richards,   R.   N. 

Frances  Hall.  R.  N. 
_.  Thora   Roberts,   R,  N. 
...  Elizabeth  Hiion,  R.   N. 
Joyce  Ely,   R.  N. 
Mary  C.  Dodd.  R.   N. 

•Field   Super  visor 


FLORIDA    STATE    BOARD    OF    HEALTH 19 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

PROPHYLACTIC   AND   THERAPEUTIC   MEASURES 

In  recent  issues  of  Health  Notes  mention  has  been  made  of  changes 
in  the  distribution  of  biologies.  The  attention  of  physicians  is  espec- 
ially invited  to  the  mling  of  the  State  Board  of  Health,  at  the  time 
of  the  December  meeting  of  the  Board,  limiting  the  free  distribution 
of  diphtheria  antitoxin  as  well  as  tetanus  antitoxin  to  the  class  of 
citizens  which  is  financially  unable  to"  pay. 

Physicians  who  apply  for  antitoxin  for  patients  in  poor  economic 
circumstances  are  asked  to  fill  in  the  blank,  which  will  accompany 
these  products,  giving  the  age,  name  and  sex  of  patient,  as  well  as 
the  name  of  the  doctor  administering  this  treatment.  The  therapeutic 
biologies  for  patients  who  do  not  come  within  this  classification  will 
be  handled  by  the  drug  stores  throughout  the  state  and  will  not  be 
generally  distributed  by  the  State  Board  of  Health  as  has  been  the 
practice  in  the  recent  past.  Prophylactic  tetanus  antitoxin  in  1500 
unit  doses  will  be  furnished  as  has  been  customary  heretofore.  As 
stated,  prophylactic  tetanus  antitoxin,  typhoid  vaccine,  smallpox  vac- 
cine and  all  strictly  prophylactic  remedies  will  be  furnished  by  the 
State  Board  of  Health  and  will  be  obtainable  from  the  laboratories 
at  Jacksonville,  Tampa,  Miami,  Pensacola  and  Tallahassee,  as  well 
as  in  certain  substations  at  logical  centers  which  will  be  announced 
later, 

Anti-Rabies  Inoculations 

Anti-rabies  vaccine  will  be  furnished  free  of  cost  to  all  who  may 
unfortunately  require  this  treatment.  This  is  regarded  as  a  prophy- 
lactic for  a  condition  in  which  the  victim  has  had  no  opportunity  of 
protecting  himself.  Rabies  exists  because  of  a  lack  of  enforcement  of 
the  simple  measures  which,  if  conscientiously  carried  out,  would  eli- 
minate this  disease  from  existence,  and  since  the  authorities  responsible 
for  this  enforcement  do  not  make  elimination  possible,  it  does  not  ap- 
pear just  that  the  victim  should  be  compelled  to  pay  for  his  misfor- 
tune. In  the  furnishing  of  this  free  treatment,  it  will  be  necessary 
for  the  physician  requesting  it  to  submit  the  name,  age  and  sex  of  the 
patient  before  treatment  will  be  sent  out.  The  treatments,  however, 
■will  be  promptly  sent  as  soon   as  this  information  is  received. 

The  general  free  distribution  of  anti-rabies  virus  will  be  effective 
after  the  first  of  February, 

Requests   for  Exclusion   of 
School  Children 

There  have  recently  been  requests  for  a  resumption  of  ruling  to 
exclude  recently  arrived  children  from  schools  for  a  period  of  two 
weeks.     The  State  Board  of  Health  does  not  see  any  justification  for 


20         /fLORIDA    STATE   BOARD    OF   HEALTH 

ADMINISTRATION 

putting  such  a  ruling  into  effect  at  the  present  time.  There  exists  no 
epidemic  at  present  which  justifies  such  a  measure;  furthermore,  ex- 
clusion from  school  does  not  accomplish  the  object  sought  in  that 
such  exclusion  applies  only  to  schools  and  the  individuals  affected  are 
permitted  to  attend  movies,  church  services,  Sunday  school  or  any 
other  public  gatherings  where  control  and  supervision  aTe  not  possible. 
With  the  present  system  of  inspection  of  the  schools  by  health  officers, 
both  local  and  state,  and  the  frequent  visits  of  public  health  nurses, 
both  local  and  state,  it  is  evident  that  there  is  a  much  more  effective 
control  of  incipient  epidemic  disease  than  in  the  case  of  children  run- 
ning at  large  without  such  supervision. 

The  State  Board  of  Health  is  zealously  watching  the  health  of 
the  citizens  of  the  state  and  with  its  ample  facilities  is  obtaining  infor- 
mation on  any  menace  and  will  institute  restrictions  and  regulations 
as  soon  as  a  logical  reason  appears.  There  is  no  occasion  for  any 
individual  or  community  to  feel  alarmed  before  an  alarm  is  sounded 
by  their  logical  health  guardian,  the  State  Board  of  Health. 

BUREAU  OF   DIAGNOSTIC  LABORATORIES 
Paul  Eaton,  M.  D..  D.  P.  H.  Director 

DOES   IT  PAY> 

The  State  Health  Department  has  for  a  number  of  years  been 
stressing  the  importance  of  immunizing  the  whole  population  against 
diphtheria.  The  mere  introduction  of  a  new  method  of  treating  this 
disease  would  not  diminish  the  number  of  cases  of  the  disease  any 
more  than  would  a  new  method  of  treating  broken  legs  diminish  the 
number  of  broken  legs  to  be  treated.  But  active  immunization  against 
diphtheria  by  the  use  of  toxin-antitoxin  or  diphtheria  toxoid  does 
diminish  the  number  of  cases  of  the  disease  as  can  be  seen  from  the 
accompanying  table: 

TABLE 


Year 

Cases   Reported 

Deaths 

Diphtheria 
Antitoxin   Distributed 

1926 

1224 

123 

31,630,000   units 

1927 

1095 

93 

26,415,000   units 

1928 

588 

580 

69 

18,490,000  units 

1929 

¥ 

22,300,000  units 

*   Deaths  for  first   1  1   months  of  1929  were  54  as  compared  with  66 
for  same  period  of  1 928. 

Leaving  everything  else  out  of  consideration  it  is  worth  while 
to  note  that  if  the  State  had  distributed  antitoxin  in  the  last  three 
years  of  this  period   at  the  same  rate  it  did   in    1926  it  would   have 


FLORIDA  STATE  BOARD  OF  HEALTH 


21 


BUREAU   OF  DIAGNOSTIC   LABORATORIES 

distributed  27,000,000  units  more  than  it  did.  This  saving  of  more 
than  $6,000.00  is  the  smallest  part  of  the  whole  saving  accomplished 
by  the  use  of  toxin-antitoxin,  as  will  be  readily  understood  by  any 
person  who  has  ever  had  a  case  of  diphtheria  in  his  family. 

SUMMARY    OF   WORK   DONE    IN   THE   LABORATORIES    OF 

THE   STATE  BOARD   OF  HEALTH 

DURING   THE   MONTH   OF  DECEMBER,    1929 

Jacksonville     Tampa      Pensacola      Miami     Tallahassee     Total 

Animal  Parasites 1697  1067  36  85  65  2950 

Diphtheria 894  232  24  576  2  1728 

Typhoid  -  370  116  14  24  30  554 

Malaria  299  122  11  19  103  554 

Rabies _ __  24  3  27 

Tuberculosis  151  68  9  52  9  289 

Gonorrhea    364  134  30  125  23  676 

Kahn 2794  1533  .514  4841 

Water:  Count  49  96  5  1  50 

Water:   Colon  «. _  134  5  139 

Milk:  Bacterial  Exam.  ...  75  99  44  288  13  519 

Milk:  Chemical  Exam.   ...  80  69  44  54  13  260 

Miscellaneous  253  58  28  356  138  833 


7001      3550 
Specimen  Containers   Distributed  — 


240      2323 


406   13520 

_ 8456 


BIOLOGICAL  PRODUCTS  DISTRIBUTED 

Diphtheria  Antitoxin 10,000  units  196  Packages 

5,000   units  114  Packages 

Toxin  Antitoxin - ■  I  3,005  C.    C. 

Schick -~ 4. 1  00  Tests 

Tetanus  Antitoxin „ 20,000   units  10  Packages 

-\         10,000   units  15  Packages 

1,500   units  564  Packages 

Anaerobic  Virus 1 00*s  8  Packages 

•JO's  24  Packages 

Typhoid  Vaccine -  614  Treatments 

Vaccine  Virus :. 4,880  Capillaries 

Antirabic  Virus _ 1 9  Treatments 

Antimeningococcus  Serum 1  9  Cylinders 

Carbon  Tetrachloride 6,71,2  Capsules 

ALL  REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 

THE  STATE  LABORATORY,   STATE  BOARD   OF  HEALTH 

JACKSONVILLE,   FLORIDA 


22 FLORIDA    STATE    BOARD    OF    HEALTH 

BUREAU   OF   COMMUNICABLE   DISEASES 
F.  A.  Brink,  M.  D.,  Director 

THE  NEW  PUBLIC  HEALTH 

Many  who  read  Florida  Health  Notes  can  recall  the  public  health 
practices  of  earlier  days  when  the  chief  duties  of  the  health  officer 
were  to  placard  and  fumigate. 

In  his  "Looking  Backward  Over  Fifty,  Years  of  Public  Health 
Work  in  Florida,"'  (Journal,  Florida  Medical  Association,  August, 
1925,  et  seq.)  the  late  Dr.  J.  Y.  Porter,  Sr.,  referred  to  some  of  the 
control  measures  then  in  vogue,  measures  that  now  seem  crude  as 
some  of  ours  may  seem  to  another  generation.  Of  special  interest 
is  the  firing  of  cannon  and  burning  tar  to  make  a  smudge  for  yellow 
fever  control.  You  from  other  states  will  recall  the  use  of  asafoetida 
to  keep  off  measles  and  the  "mad  stone"  for  rabies,  not  to  mention 
the  pudding  and  molasses  diet  to  render  mild  an  attack  of  smallpox. 

The  very  word  quarantine  signifies  an  arbitrary  isolation  period  of 
forty  days  which  period  has  been  modified  to  accord  with  increased 
knowledge  about  the  mode  of  transmission  and  period  of  communica- 
bility  for  each  contagious  disease. 

Little  wonder  that  doubt  arose  in  the  lay  mind  and  protests  were 
heard  when  the  placing  of  armed  guards  failed  to  prevent  the  spread 
of  yellow  fever  while  the  insect  carrier  was  hatched  in  every  home 
and  allowed  to  migrate  and  bite,  unhampered  by  screen  or  net.  Doubts 
and  complaints  are  always  heard  when  any  communicable  disease  con- 
trol measure  interferes  with  usual  human  activities,  particularly  if  the 
measure  is  one  to  which  people  are  not  accustomed. 

The  early  health  officer  with  his  arbitrary  quarantine  period  and 
sulphur  or  formalin  fumigation  undoubtedly  accomplished  considerable 
good.  The  progress  of  epidemics  must  have  been  retarded  and  his 
services  were  worthy  of  appreciation.  The  writer  should  know,  having 
served  his  day  as  part  time  health  officer  in  a  rural  area  during  a 
smallpox  epidemic  in  1  909.  But  for  the  satisfaction  of  knowing  one's 
duty  and  doing  it  and  the  harsh  comments  from  some  of  the  clientele, 
the  emoluments  as  usual,  were  nil. 

The  health  officer  of  twenty  or  thirty  years  ago  did  not  concern 
himself  with  tonsils  and  adenoids,  dental  care  or  defects  of  vision. 
These  received  attention  only  ■when  they  became  so  troublesome  as  to 
require  the  care  of  the  family  physician  or  the  dentist  whose  main 
business  was  to  pull  teeth.  The  resultant  harvest  of  rheumatism,  heart 
disease,  Brights,  headaches,  nervous  manifestations  and  many  other 
complaints  must  have  added  greatly  to  the  doctor's  worries  and  the 
patients*  distress.  Many  of  these  deformities  and  infirmities  of  other 
days  have  now  become   rare. 

Many  will  recall  hearing  about  "the  germ  theory  of  consump- 
tion*". Pasteur  gave  his  first  antirabic  treatment  in  1880  and  diph- 
theria antitoxin  was  first  used  in   1893. 


FLORIDA    STATE    BOARD    OF    HEALTH 23 

BUREAU   OF  COMMUNICABLE   DISEASES 

The  use  of  the  compound  microscope,  the  methods  of  isolating 
and  culturing  bacteria  and  studying  experimentally  the  resultant  growth 
and  toxin  production  have  added  vastly  to  our  knowledge  of  bacterial 
and  other  diseases. 

To  Jenner,  Pasteur,  Lister,  Reed,  Gorgas  and  a  host  of  others,  we 
owe  a  debt  of  gratitude.  As  a  result  of  knowledge  gained  through 
their  labors  many  safeguards  have  been  thrown  about  the  public  health 
and  the  individual.  The  technique  of  preparing,  distributing  and  ad- 
ministering smallpox  vaccine  has  been  greatly  refined,  safe  and  ef- 
fective methods  of  immunizing  against  other  communicable  diseases 
have  been  developed,  numerous  curative  serums  are  available,  the 
mode  of  transmission  and  new  measures  for  the  control  of  infection 
have  been  discovered.  With  but  few  exceptions  the  spread  of  disease 
in  epidemic  form  indicates  carelessness,  neglect,  inefficiency  or  inade- 
quate provision  for  health  protection. 

With  increasing  density  of  population,  the  need  of  health  service 
has  increased  and  that  need  has  been  partially  met.  Our  conception 
of  what  constitutes  the  field  of  public  health  has  changed.  Many 
phases  of  human  activity  have  a  definite  relationship  to  health.  The 
well  ordered  health  department  must  choose  and  lay  stress  on  those 
activities  that  will  benefit  most,  the  largest  possible  number  of  people. 

Education — health  propaganda,  if  you  please, — is  and  must  re- 
main a  most  valuable  phase  of  our  -work.  With  the  intelligent  co- 
operation of  an  enlightened  people  your  health  department  can  further 
safeguard  your  household  and  community  from  costly  but  preventable 
sickness. 

The  Physician 

The  family  doctor,  though  he  may  be  relieved  of  certain  respon- 
sibilities by  the  new  public  health  program,  will  find  new  problems, 
new  duties  -and  new  services  to  render  bis  patients;  his  importance 
to  the  community  must  increase,  his  status  must  improve  with  that  of 
his  community.  As  in  the  past  he  will  prosper  in  proportion  to  the 
increasing  value   of  the  service  he  is  able  to  render. 


HEALTH  ECONOMICS 

Did  you  ever  compare  the  cost  of  preventable  sickness  with  that 
of  adequate  protection? 

Try  it  once.  On  the  one  hand  you  have  the  cost  of  medical  care, 
nursing,  drugs,  lost  time,  loss  to  business  and  decreased  production 
of  farm,  dairy,  factory  or  mill.  On  the  other  hand,  there  is  your 
share  of  tax  money  (perhaps  25 £  per  capita)  for  the  health  depart- 
ment, cost  of  screens,  cost  of  adequate  means  for  disposal  of  wastes, 
proper  diet  a^id  an  annual  health  examination.  You  might  be  sur- 
prised to  know  what  a  large  balance  will  appear  in  favor  of  preven- 
tion and  that  without  considering  the  comfort  and  convenience  which 
alone  are  worth  all  the  cost  of  the  precautionary  measures. 


24 FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU   OF   ENGINEERING 
Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

MOSQUITO  CONTROL  AT   FT.  PIERCE 

The  third  annual  report  of  the  St.  Lucie  County  Sanitary  Dis- 
trict, W.  I.  Fee,  Ft.  Pierce,  chairman,  has  been  received  and  is  a  most 
interesting  resume  of  the  work  which  has  been  so  ably  carried  on  by 
Mr.  Fee  and  his  fellow  workers. 

Ft.  Pierce  has  long  had  the  reputation  of  being  "mosquito  hea- 
ven" due  to  the  hordes  of  Aedes  taeniorhynchus  that  infest  the  city 
and  county  communities  along  the  Indian  River.  The  mangrove  salt 
marshes  on  the  "island"  or  peninsula  lying  between  the  Atlantic 
Ocean  and  the  famed  Indian  River,  following  high  tides,  heavy  rain- 
fall or  both,  produce  billions  of  mosquitoes.  As  the  Aedes  taeniorhyn- 
chus lays  her  eggs  upon  the  dry  marsh,  which  will  later  j)§J  flooded, 
these  eggs  accumulate  day  by  day  until  the  high  waters  reach  them. 
Then  they  all  start  to  hatch  and  the  entire  crop  comes  off  at  one  time 
making  a  definite  infestation  date.  The  hordes  of  mosquitoes  will 
gradually  disappear  but  flight  predictions  can  readily  be  made  by 
studies  of  rainfall,  tidal  range  and  a  knowledge  of  the  mangrove  areas. 
These  flights  have  made  existence  miserable  for  man  and  animals  along 
the  river,  and  have  very  seriously  curtailed  the  development  of  the 
section  during  the  summer.  Little  work  can  be  done  in  the  open  when 
an  infestation  is  on.  Even  railroad  track  crews  have  to  be  so  bundled 
up  in  clothing  that  they  can  hardly  work.  Construction  work  practi- 
cally ceases.  Gradually  the  flight  migrates  inland  and  disappears. 
In  August  1926,  Norman  G.  Platrs,  city  health  officer  of  Ft.  Pierce, 
commenced  the  first  year-round  scientific  study  of  conditions  in  man- 
grove mosquito  breeding  areas.  Mr,  Platts  has  since  continued  his 
observations  and  has  been  engaged  in  the  actual  control  program. 
Early  observations  led  the  district  officials  to  abandon   the  proposal 

of  spending  $50G,f)00  on  a  diking  and  pumping drainage  proposal, 

which  had  been  advanced  by  W.  D.  Wrightston  and  voted  upon" 
favorably  by  the  people.  The  plan  adopted  consisted  primarily  of 
drainage  ditches  or,  as  Mr.  Fee  calls  them,  "minnow  (Gambusia  af- 
finis)  access  ditches."  The  procedure  adopted  is  to  clear  right-of- 
ways  through  the  mangrove  growths  to  reach  the  numerous  open 
areas  which  are  covered  with  dense  growths  of  "pickle  weed."  Ditches 
are  dynamited  or  hand  dug  to  open  these  areas  to  the  Indian  River. 
No  attempt  at  drainage  to  the  ocean  is  made.  An  extensive  net  work 
of  parallel  ditches  all  over  the  mangrove  and  pickle  weed  areas  is 
created  so  that  all  the  ponds,  sloughs,  la^ge1  shallow  basins,  etc.,  are 
connected  to  the  Indian  River.  Arterial  ditches  are  dynamited  while 
laterals  and  secondary  ditches  hand  dug.  These  ditches  allow,  first, 
a  quick  run-off  or  drainage  of  rainfall  or  tide  thus  decreasing  the  breed- 
ing grounds  from  thousands  of  acres  to  hundreds  before  the  eggs  start 
hatching.  Also  thousands  of  eggs  and  young  larvae  are  carried  to  the 
river.  Secondly,  thousands  of  minnows  follow  up  these  ditches  and 
work  in  the  very  shallow  areas  at  the  head  waters  eating  larvae  that 


FLORIDA  STATE  BOARD  OF  HEALTH 25 

BUREAU   OF  ENGINEERING 

otherwise  would  hatch  out.  Extensive  observations  as  to  growths  and 
area  to  be  covered  are  the  guides  to  economical  ditching  operations 
and  Mr.  Platts  has  covered  the  "island"  very  thoroughly.  Air  plane 
maps  are  also  used  to  spot  low  areas. 

In  1927,  the  City  of  Ft.  Pierce  largely  financed  the  operations 
and  16.69  miles  of  ditches  were  constructed  in  the  very  worst  area 
directly  across  from  the  city.  $8,040.13  was  thus  spent.  The  sum- 
mer of  1  927  was  a  very  dry  one  and  the  season  was  fairly  free  of  flight. 

In  1  928,  a  six  mill  tax  on  the  district  was  collected  in  accord  with 
a  special  Act  of  the  1927  legislature  pertaining  to  this  district. 
$22,900  was  collected.  35.69  miles  of  ditches  were  constructed  and 
the  1927  system  maintained  and  improved.  Some  freedom  from  the 
pests  resulted  but  an  August  gale  blocked  some  of  the  ditches  through 
blown  down  timber,  etc.,  and  an  "old  time"  flight  resulted.  The 
result  of  this  storm  and  flight  was  to  increase  the  widths  of  ditch 
clearing  and  to  add  more  lateral  ditches. 

In  1929,  the  six  mill  levy  produced  $20,498  and  49.98  miles 
were  added  during  the  summer  to  the  drainage  ditch  system  in  the 
island.  Thus,  there  are  102.36  miles  of  ditches  now  functioning  on 
the  island.  The  season  was  a  good  one  for  mosquitoes — abundant 
rainfall,  high  tide,  cloudy  days,  favorable  winds.  In  other  localities 
the  mosquitoes  were  very  bad  but  in  Ft.  Pierce  there  were  less  than 
ever  known  before.  People  who  formerly  would  not  stop  overnight 
in  Ft.  Pierce  now  make  it  their  stopping  place — for  Ft.  Pierce  is  more 
nearly  free  of  mosquitoes  than  other  nearby  points.  Traveling  men 
have  commented  on  the  lessened  numbers  of  mosquitoes.  Early  re- 
turning winter  residents  remark  on  their  absence.  The  stores  report 
steadily  decreasing  sales  of  "skeeter  dope*' — spray  guns,  etc.,  and  even 
screen  wire!  It  is  not  claimed  that  the  control  is  100  per  cent  in 
results  for  some  infestations  have  occurred.  These,  however,  have 
only  been  estimated  as  about  I  0  per  cent  of  former  infestations.  As 
the  flight  range  of  the  Aedes  taeniorhynchus  is  about  1  0  miles,  remote 
areas  still  produce  the  usual  hordes  and  some  drift  into  the  center  of 
the  control  area. 

The  work  is  about  two-thirds  done  in  the  salt  marsh  areas.  The 
section  north  of  the  inlet,  which  was  opened  in  1  929,  is  largely  com- 
plete but  the  finishing  ditches  will  be  put  in  this  year.  South  of  the 
inlet  a  bad  area  is  opposite  Eden  and  continues  to  the  Martin  County 
line.  This  should  be  covered  this  year.  The  ditches  seem  to  stand 
up  very  well  as  the  soil  is  very  mucky  and  largely  matted  with  roots. 
The  very  flat  gradients  available  keep  down  scouring  action.  The 
future  looms  bright  for  Ft.  Pierce.  Their  new  port  is  open  and  their 
most  destructive  advertisement,  the  mosquito,  is  on  the  wane.  Thus, 
St.  Lucie  County  has  made  a  fine  contribution  to  science — a  contri- 
bution due  largely  to  the  perserverance  and  undying  optimism  and 
faith  of  Mr.  W.  I.  Fee.  Mr.  Platts  has  carried  on  the  actual  field  work 
and  deserves  high  commendation.  All-together,  $56,555.26  has  been 
collected  for  this  work — less  than  two  years'  interest  at  six  per  cent  on 


26 FLORIDA    STATE   BOARD   OF   HEALTH 

BUREAU   OF  ENGINEERING 

the  bond  issue,  and  $2,412.70  is  on  hand  in  county  banks.  In  the 
area  north  of  the  inlet  eight  miles  of  hand  ditches  and  13  miles  of 
dynamited  ditch  have  been  built,  in  the  inlet  to  Mud  Creek  area,  26 
miles  hand  and  18  miles  dynamite  ditch;  Mud  Creek  south  towards 
Martin  County  line,  30  miles  hand  ditches  and  1  I  miles  of  dynamited 
ditch.  It  is  estimated  that  4,000  of  the  6,000  acres  of  salt  marsh — 
mangrove  in  the  county  are  controlled  by  these  ditches.  The  equip- 
ment consists  of  a  26  foot  launch  with  an  18  horse  engine,  one  20 
foot  scow,  one  1 8  foot  skiff,  one  1 6  foot  skiff,  one  Evinrude  motor, 
one  Graham  2  ton  truck,  axes,  shovels  and  other  tools. 

That  Aedes  taeniorhynchus  can  be  controlled  has  been  practically 
demonstrated  at  Ft.  Pierce  at  a  very  reasonable  cost.  Other  counties 
can  organize — Palm  Beach  under  the  able  leadership  of  A.  E.  Detwiler 
of  Lake  Worth  is  about  ready  to  go.  Indian  River  County  under  Alec 
McWilliams  is  carrying  on  its  work  started  several  years  ago.  Martin 
County  has  dropped  its  work  due  to  unfortunate  circumstances. 

Salt  marsh  mosquitoes  can  be  controlled.  We  can  control  malaria 
transmitting  mosquitoes,  Anopheles  quadrimaculatus,  also  by  similar 
operations  and  far  more  reasonably  as  their  flight  range  is  less.  Why 
should  Florida  have  mosquitoes?  An  awakened  public  led  by  a  few 
enthusiasts  such  as  Mr.  Fee  at  Ft,  Pierce  can  do  it.  We  must  do  it 
if  Florida  is  to  come  into  her  own.  A  full  report  of  the  St,  Lucie 
County  Sanitary  District  operations  can  be  secured  from  Mr.  W.  I. 
Fee.   at  Ft.   Pierce.      IT  CAN  BE  DONE. 


CHILD   HYGIENE   AND    PUBLIC    HEALTH    NURSING 
Clio  McLaughlin,  R,  N.,  Acting  Director 

WHAT  IS  HEALTH  ? 

Probably  the  most  widely  discussed  subject  of  the  present  time 
is  Health.  How  few  of  us  know  the  real  meaning  of  the  word.  (To 
most  people  the  word  "health"  means  merely  a  sound  body,  free  from 
disease.)  Health,  however,  means  more  than  a  well  body.  It  means 
a  sound,  whole  body,  mind  and  soul,  well  being,  no  weak  spots,  all 
organs  able  to  function  properly,  whole  in  mind  as  well  as  body.  Sel- 
dom do  we  find  a  straight  thinking  mind  in  a  diseased  body. 

It  is  with  the  idea  of  attaining  perfect  health  for  our  country  that 
the  medical  profession  and  health  departments  are  working  today. 
It  is  for  this  that  public  health  nurses  are  in  the  field  teaching  people 
in  the  towns  and  rural  districts  some  of  the  secrets  and  blessings  of 
health  and  advising  mothers  about  the  care  of  their  children  so  that 
we  may  have  strong,  stalwart  citizens  in  time  to  come. 

Health  is  a  community  problem.  To  have  good  strong  communi- 
ties, each  individual  must  learn  the  importance  of  keeping  well  and  the 
genera)  rules  for  doing  so.  Each  citizen  has  his  contribution  to  make 
whether  he  be  a  patient,  a  doctor,  a  nurse,  or  a  public  health  official. 
On  the  health  stage,  every  citizen  must  play  his  part.      Parents  must 


FLORIDA  STATE  BOARD  OF  HEALTH 27 

CHILD    HYGIENE   AND   PUBLIC    HEALTH    NURSING 

be  able  to  guide   their  children  in  right  thinking  aa  well  as  in   the 
care  of  their  bodies.      It  is  as  much  a   social  as  a  personal  problem. 

Slowly,  but  very  surely,  public  health  workers  are  instilling  into 
the  minds  of  the  general  public  the  idea  that  many  of  their  sufferings 
spring  from  neglect  of  the  simple  laws  of  health,  for  one  cannot  dis- 
regard these  laws  and  keep  well.  The  time  is  coming,  we  believe,  when 
society  will  adopt  universal   health  as  an  ideal. 

People  have  been  informed  that  by  suitable  preventive  measures, 
epidemics  can  be  avoided  and  thousands  of  dollars  saved.  They 
know  that  small-pox,  typhoid  fever,  diphtheria,  hookworm,  and 
malaria,  if  not  prevented,  lower  the  morale  of  the  community,  reduce 
personal  efficiency,  reduce  community  prosperity,  and  that  they  af- 
fect the  business  man  as  well  as  the  farmer.  Each  person  should 
take  an  interest  in  his  or  her  community  and  if  this  is  done,  together 
with  the  effort  being  put  forth  by  the  medical  authorities,  there  is  no 
reason  why  health  in  Florida  should  not  rank  first  among  the  states. 

Recently,  a  Florida  health  nurse  sent  into  the  office  of  the  State 
Board  of  Health  her  plan  of  health  work  for  the  coming  year.  This 
included  prenatal  classes,  Little  Mothers"  League,  infant  and  preschool 
conferences,  literature  for  children  and  grown-ups,  and  entertainment 
for  children.  The  clearly  defined  program  showed  a  broad  vision 
and  thorough  understanding  on  the  part  of  the  nurse  of  problems  to 
be  dealt  with,  since  eveiy  phase  of  health  work  was  covered.  Enter- 
tainment for  children  is  quite  as  essential  to  their  good  health  as  clean 
teeth  and  clean  hands,  since  it  gives  them  an  opportunity  to  develop 
personality  through  straight  thinking  rather  than  through  some  other 
technique.  For  instance,  the  child  that  has  a  wound  dressed  and  does 
not  cry  but  says  at  the  conclusion.  "There  now.  I  am  a  real  man,"  gives 
much  greater  promise  of  becoming  an  influential  citizen  than  the  child 
who  torments  his  mother  for  an  apple  and  is  told  that  if  he  asks  again 
he  will  be  spanked,  calls  to  his  mother,  "Mother,  when  you  come  up  to 
spank  me,  bring  me  an  apple."  Children  of  the  latter  type  are  a 
nuisance  not  only  to  their  parents  and  teachers  but  to  the  community 
at  large.  Florida  wants  citizens  of  the  former  type — good  substantial 
men  and  women. 

The  nurses  in  the  state  also  work  up  tonsil  and  chest 
clinics.  These  clinics  are  sponsored  by  the  different  local  clubs  and 
the  doctors  in  the  districts  do   the  work  for  a  nominal  sum. 

All  of  this  goes  to  show  that  almost  everyone  is  "On  the  job  in 
Florida" —  which  means  that  Florida  will  attain  the  goal  for  which 
she  ts  striving.  If  we  have  healthy  children,  they  are  able  to  enter 
school  at  the  appointed  time  and  thereby  avoid  growing  to  old  age 
without  being  able  to  write  their  names.  Illiterates  as  a  rule  are  the 
law  breakers  and  the  ruin  of  the  country,  not  always  intentionally,  but 
because  of  their  inability  to  read  and  know  the  things  that  stand  for 
good  citizenship. 


28 FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU    OF    VITAL    STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

AVERAGE  LIFE  SPAN  SHORTER 

In  the  July  publication  of  "Science"',  Professor 
C.  H.  Forsyth  of  Dartmouth  College  declares  there 
is  a  decline  in  the  average  length  of  life  and  takes 
issue  with  those  who  are  so  elated  with  results  ob- 
tained in  their  own  immediate  fields  leading  to 
(Zi  »■  significant  reductions  not  only  in  certain  death-rates 

[•  FLORIDA  I*  but  also  in  the  prevalences  of  certain  diseases  that 
they  feel  justified  in  predicting  marvelous  increases 

in   the   average   length   of   the   whole   of    life   in    the   no   great   distant 

future.      Professor  Forsyth  explains: 

"Most  of  these  optimistic  authorities  have  failed  to  appreciate 
that  practically  all  these  results  have  been  attained  in  children's  di- 
seases and  that  little  or  no  attention  has  been  given  to  the  situation 
at  ages  beyond  the  prime  of  life.  The  writer  claims  that  conditions 
in  this  country  at  advanced  ages  have  been  on  the  down  grade  ever 
since  the  first  mortality  records  were  established  at  Washington  and 
that  they  have  how  reached  such  a  pass  that  all  the  great  gains  at 
Lhe  early  ages  are  already  more  than  offset  by  the  losses  at  advanced 
ages.  *  *  • 

"The  main  results,  shown  here,  were  obtained  from  abridged 
mortality  tables  constructed  from  the  population  and  mortality  sta- 
tistics of  the  males  of  what  are  now  known  as  the  original  registration 
states — the   New   England   states   and   Indiana,    New  Jersey  and   New 

York or    the    only    states    which    have    supplied    satisfactory    records 

of  deaths  ever  since  1 900 — and  even  1 890.  *  *  *  The  results  for 
the  females  are  not  given  here  but  present  the  same  picture — in 
somewhat  less  smooth   form. 

"It  will  be  understood,  of  course,  that  there  is  an  average  length 
of  life  corresponding  to  each  age — the  average  lengtft  from  that  age 
on — although  it  is  usually  called  the  expectation  of  life  in  that  case. 
In  working  with  abridged  mortality  tables,  it  is  necessary  to  omit  the 

first  few  ages say.   before  age  ten — -for  well-known  reasons,   but  the 

expectation  at  age  ten  is  usually  a  rough  approximation  of  the  average 
length  of  the  whole  of  life.  *  *  * 

"Every  one  has  been  familiar  with  the  consistent  improvement 
of  conditions  at  earlier  ages  and  some  have  been  more  or  less  aware 
of  the  situation  at  advanced  ages,  but"  there  is  no  printed  evidence 
that  any  one  was  sufficiently  aware  of  the  seriousness  of  the  latter 
situation  to  propose  the  pertinent  question  of  whether  the  latter  situa- 
tion would  ever  develop  to  the  point  where  it  would  dominate.  In 
any  case,  the  question  is  no  longer  pertinent — the  decline  at  advanced 
ages  already  dominates  and  the  average  length  of  life — or  at  least  the 
expectation  from  age  ten — is  already  going  down.   *   *   * 


FLORIDA  STATE  BOARD  OF  HEALTH     '  ^ 


BUREAU    OF    VITAL    STATISTICS 


) 


"It  is  well  to  recognize  that  improvement  at  the  early  ages  has 
a  rather  definite  limit  and  that  the  decline  at  advanced  ages  has  no 
appreciable  limit.  It  follows  naturally  that  with  all  the  improvement 
in  the  world  at  the  early  ages,  the  present  downward  trend  at  the 
advanced  ages,  if  unchecked,  will  continue  to  dominate  and  produce 
a  greater  and  greater  net  decline  in  the  average  length  of  life. 

"The  great  decline  at  advanced  ages  is  remarkably  concentrated 
about  age  seventy  although  it  extends  as  far  back  as  age  forty.  *  *  * 

"To  me,  the  whole  picture,  from  our  earliest  records  in  1890 
to  the  present  time,  points  consistently  and  inevitably  to  a  future  of 
a  declining  average  length  of  life  until  the  American  adult  wakes 
up  to  the  fact  that  the  odds  are  at  present  heavily  against  his  living 
as  long  as  his  father  or  grandfather.  Some  will  say — and  no  doubt 
truly — that  it  is  all  a  natural  consequence  of  the  great  drift  to  the 
cities.  Others  will  go  farther  and  say  that  life  has  become  too  fast 
and  strenous  and  that  we  do  not  know  as  yet  how  to  adjust  ourselves 
to  such  a  life.  To  the  medical  authorities  the  whole  problem  will 
loom  as  one  of  relieving  the  strain  upon  the  heart.  But  little  will  be 
accomplished  until  the  American  adult  himself  is  duly  informed  and 
made  to  realize  that  he  is  in  the  midst  oifci  decidedly  losing  fight  and 
that  the  situation  will  continue  until  he  applies  himself  energetically 
to  be  superior  to  his  environment.  Moreover,  each  adult  must  fight 
his  own  individual  battle,  since  he  usually  brooks  no  interference  with 
his  own  individual  mode  of  living.  Medical  authorities  and  scientists 
can  be  depended  upon  to  care  for  the  children  and  their  diseases,  but 
they  have  little  or  no  chance  to  interfere  with  the  lives  of  adults. 

"It  truly  looks  as  if  it  is  going  to  be  a  losing  fight  for  some  time 
to  come,  for  although  some  adults  are  making  commendable  effort 
to  live  sane  lives,  the  vast  majority  seem  very  indifferent  and  many 
give  apparently  no  thought  whatever  to  habits  which  they  clearly 
know  are  bad  and  which  they  know  they  could  easily  discard.  There 
is  surely  no  worse  influence  than  that  welded  by  well-meaning  authori- 
ties who  go  around  airing  their  ill-founded  beliefs  that  all  is  going  well 
and  that  before  long  everybody  is  going  to  be  living  seventy-five  to  a 
hundred  years!" 


TO    LIBRARIANS 

The  Bureau  has  available,  a  limited  number  of  bound  copies  of 
Florida  Health  Notes.  These  bound  volumes  "will  be  sent  free  of 
charge  to  librarians,  health  and  other  organizations  as  long  as  the 
supply  lasts. 


30 FLORIDA   STATE   BOARD    OF  HEALTH 

BUREAU  OF  VITAL  STATISTICS 

PUBLIC  HEALTH  INSTITUTE 

The  Public  Health  Institute  'will  be  held  in  Jacksonville,  Monday, 
Tuesday  and  Wednesday,  February  10-12,  1930;  to  be  conducted 
by  the  National  Tuberculosis  Association  and  the  Florida  Public  Health 
Association  in  cooperation  with  the  Florida  State  Board  of  Health. 
Philip  P,  Jacobs,  Ph,  D.,  of  Columbia  University  and  the  National 
Tuberculosis  Association,  is  in  charge  of  the  course  which  will  con- 
sist of  lectures,  discussions  and  field  trips.  The  Institute  is  primarily 
designed  for  lay  persons  interested  in  health  work  and  for  professional 
public  health  workers  interested  in  the  underlying  theory  and  the  ad- 
ministrative and  educational  phases  of  their  work.  Tuition  for  the 
course  will  be  $5.00.  A  limited  number  of  scholarships  are  available. 
All  meetings  will  be  held  at  the  Mayflower  Hotel,  Jacksonville. 
For  blanks,  information,  etc.,  address  4  East  Bay  Street,  Jacksonville, 
Florida. 


YALE  ESTABLISHES  MONKEY  FARM  AT 
ORANGE  PARK,  FLORIDA 

The  Rockefeller  Foundation  has  given  $500,000  to  Yale  Univer- 
sity, New  Haven,  Conn.,  -which  ■will  be  used  to  establish  a  laboratory 
station  on  a  200  acre  tract  at  Orange  Park  for  the  breeding  and 
scientific  study  of  anthropoid  apes.  A  special  laboratory  will  be 
built  in  which  will  be  made  a  detailed  observation  of  the  habits,  social 
relations,  life  history  and  the  psychobiologic  development  of  the 
chimpanzee,  the  gorilla,  the  orangutan  and  the  gibbon.  It  is"  thought 
the  exhaustive  studies  of  anthropoids  will  be  of  great  importance  in 
connection  with  the  program  of  the  Institute  of  Human  Relations  at 
Yale,  The  studies  will  include  problems  in  physiology,  behavioral^— " 
adaptivity,  mental  defects  and  diseases  among  the  apes,  and  it  vt\y 
be  under  the  general  supervision  of  Robert  M.  Yerkes,  Ph.  D.,  who 
has  been  at  work  at  Yale  for  five  years  on  comparative  psychobiology. 


The  following  tables  indicate  the  number  of  deaths  from  certain 

diseases  by  months,    for    1929   as   compared   with  the  previous   year. 
(Provisional  figures.) 

TYPHOID    DEATHS 

Jan*      Feb.      Mar.      Apr.      May      June       July      Aug.  Sept.      Oct,      Nov,   Tola! 

1 9  2  9 2       4        5      Tl        8      T 1       13        6  4        5        4~7 3 

1928,-. 7        2     _9_ 4      18      12      19      14  7      14       9    115 

MALARIA    DEATHS 

Jan.      Feb.      Mar.      Apr*      May      June       July      Aug.  5epL>      Oct,      Nov.   Total 

1929 _  24   7   T5~Hnr30—36—60—57—68— 65  "33^409 

1928...     9   9   13   10  24  16  26  36  39  84  74  340 

DIPHTHERIA  DEATHS 

Jan.      Feb-      Mat,      Apr.      May     June       July     Aug.  Sept.      Oct,      Nov.  Total 

1 929 _    8        6        T~    3       .3        1         1        8  9        6        6      54 

1928            13        7        4        4        5        2        6        8  4        76     66 

i 


FLORIDA    STATE   BOARD    OF   HEALTH 


31 


BUREAU   OF   VITAL   STATISTICS 


^PROVISIONAL  MORTALITY  FOR  NOVEMBER.  1 929 


IntVI 

I  List  No, 

(1920) 


1-205 
I 

5 

6 

7 

8 

9 

10 

II 

22 

23 

24 

31-37 

43-49 

54 

57 

70-86 

74 

87-96 

87-90 

97-107 

100-101 

108-127 

113 

128-142 

128-129 

143-150 


FLORIDA 


ALL  CAUSES- 

Typhoid — 

Malaria..— 

Smallpox. — 

Measles.. 





Scarlet  fever_ — _ 

Whooping  cough 

Diphtheria™ 

Influenza 

Acute  anterior  poliomyelitis. 
Lethargic   encephalitis.. 
Meningococcus  meningitis 
Tuberculosis — 'all  forms...... 

Cancer — all   forms— — 
Pellagra.. 


Diabetes    mellitus.. 


Diseases  of  the  nervous  system. 

Cerebral  hemorrhage,  apoplexy.. 
Diseases  of  the  circulatory  system.. 

Diseases  of  the   heart.. 

Diseases  of  the  respiratory  system.. 

Pneumonia — all   forms — 

Diseases  of  the  digestive   system 


Diarrhea  and  enteritis   (under  2  years). 


Nonvenereal  diseases  of  the  genitourinary  system 

Nephritis all    forms ■■  — 

The  puerperal  state .  „.. .—.—..,■ ,. 


Number  of  death* 


Total       White    Colored 


INFANT  MORTALITY 


Number  of  LIVE  BIRTHS.... 
Number  of  STILL  BIRTHS- 
Number  of  DEATHS  under    I    year. 
By  cause:   (deaths  under    I   year). 


Infectious  diseases   {1-42,  exc.    II    31,   37a )^.. 

Respiratory  diseases    (II.    31.    37a.    97-107)    .. 

Castro-intestinal  diseases    (1  12,    I  13) 

Malformations  and  early  infancy    (159-163)  — 

Premature  birth    (161a) 

Injury  at  birth   (161  b) 


1.415 

4 

47 

0 

0 

0 

2 

8 

27 

0 

2 

1 

88 

79 

24 

12 

139 

98 

221 

199 

81 

69 

121 

17 

170 

143 

20 


2.231 

136 

129 

100 

9 

14 

13 

65 

39 

7 


855 

I 

29 

0 

0 

0 

I 

7 

M 

0 

2 

I 

38 

63 

9 

8 

86 

56 

144 

128 

45 

38 

79 

10 

109 

94 

16 


1.497 
68 
73 
55 

5 
7 
4 
40 
25 
4 


560 
3 
IS 
0 
0 
0 
I 

16 

0 

0 

0 

50 

16 

15 

4 

53 

42 

77 

71 

36 

31 

42 

7 

61 

49 

4 


734 

68 

56 

45 

4 

7 

9 

25 

14 

3 


ALL  CAUSES.  BY  ACE 


Deaths 

I    129 

I    187 

M      61 

»   1    114 

'  1        8 

Age* 

Deaths 

Ages 

2 

Denths 

]    10 

Ages 

Deaths 

Asci 

Deaths 

Age*       Deaths 

1           1 

33 

3 

8 

4 

A 

Und.5    |     191 

5-9     1 

19 

10-14 

1        9 

15-19 
45-49 

50 
101 

20-24 

60 

25-29   |      73 

35-39    | 

76 

40-44 
70-74 

i      69 
|      99 

50-54 

79 

55-59  |    105 

65-69    < 
95-99    | 

99 

2 

75-79 

78 

80-84 

54 

85-89   i      37 

1  00- 

I        «| 

Unk. 

14 

Total   11.415 

lludes  delayed  Certificates 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


vurOnk 
VoodHealin 
Qentine/ 


CUT 

our  on 


C0U3RED 
PAPER 


lake jour  crayons  and  dee  how  nicely 
*«yDU  can  color  the  pictures  inside  of 
the  bi<J  heart.  Then  cut  rt  out  carefully 
alow}  the  lace" outlines.  Mount  it  on  a 
larger  piece  of  colored  paper.  Next, 
cut  out  the  smaller  heart,  (b)  aid  paste 
the  flap  on. .space  A  in  the  large  heart 
soyw  can  lift  it  up  tonad  the  ptiule 
looks  "when  message.  Do  this  by  holding  the  paper 
--finished-     almost  on  level  wi  thine  ejas  ^ — "^~y^ 


How  it 


This  Issue  Exceeds  1  1,000  Copiea 


pUORlD^ 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN  ** 

ESTABLISHED   JULY,    1892 

STATE  BOARD  OF  HEALTH 


Entered  as  Second  Class   Matter.  October  2?,    1921 
at   the    Postofffea  at    Jackson vilJe.    Florida,    Under    the   Act    of    Auguit    24.     1912 


JACKSONVILLE,  FLORIDA 

red  as  Second  Class  Matter,  October   27. 

t    Jacksonville.    Florida,    Under    the   Act    c 

Thi>  Bulletin  will  be  sent   to  any  address  in  the  State   free  of  charge. 

Vol.  22  MARCH  1930  No.  3 

i  , 

Edited  by 
ksiEW£RT  G.  THOMPSON,  D.P.H.,  Member 

American   Medical   Editors'   and   Author*'   Asin. 

J         ■ 

SPECIAL   ARTICLES 

THE  CIRCUS— Hanson 

MAY  DAY  —  McLaughlin 

HEALTH  PICTURES— Brink 

MOSQUITO   MEETING  —  Filby 

AGE  GROUP,  1  to  4,  Inc. — Thompson 

THE  FUNCTION  OF  A  STATE  LABORATORY— Eaton 


HENRY  HANSON,  M.  D-  STATE  HEALTH  OFFICER 


34 


FLORIDA    STATE    BOARD    OF    HEALTH 


Chna*    H.    Mann,    Pres. 
Jacksonville 


BOARD  MEMBERS 


H,    Mason    Smith, 
Tamps 


M.    D. 


Wm.  D.  Noble..  M.  D. 
Pen  sucti  1ft 


STATE  HEALTH  OFFICER 


Henry    Hanson,     M- 

BUREAUS  AT  JACKSONVILLE 


DIRECTORS 


Diagnostic    Laboratories  _ 
■Vital    Statistics- 


Communicable    Diseases- 
Engineering-. 


Child  Hygiene  and  Public  Health  Nursing. 
Accoun  ting , — ^^ 

Crippled   Children- 


Paul  Eaton.  M.  D-,  D.  P.  H. 

Stewart    G.    Thompson.    D.    P. 

F.  A,  Brink,   M.   D. 

Ellsworth   L,   Filby,  C    E. 

Luc  Lie    Spire    B 1  a  c  h  1  y ,    M .     D . 
»,    Screven    Dozier 
™   F.    L.   Fort,   M.  D. 


H 


* 55 0   Local  Registrars    (County  Hat  furnished  on  request). 

•Registration    Inspector . Anna  C  Emmons 

Drug  Store  Inspector . H.  R.  Monroe 

Drug    Store    Inspector W.    A-    Mahoney 


LABORATORIES 


Jacksonville.. 

Miami . 

Pep  sa  co  la —. 

Tallahassee 

Tampa 


Pearl   Griffith.   B.   E, 
E.  R-    Powell 
Jnnie    B*   Currie,   B,   3. 
Elizabeth    Byrd,    B.    S. 
H.    D.   Venters.    B     3, 


MEDICAL  OFFICERS 


DeFuniak    Spring* 
la  ckaon  ville 

M  el  bo  urne 

Qu  in  cy— — „ — ,  

Tallahassee.— 

Tampa 


C.    W,    McDonald,    M.    D. 
B.   C.    Wilson.   M.   D 
W.   A.    Oaiton,    M.    D. 
A.  C.  Hamblin.   M.  D. 
A.    P.    Harrison,    M.    D 
Chni.   W.  Pease.   M     D. 


DISTRICT   SANITARY    OFFICERS 


Tampa  . 
Jacksonville 
rliami 


Ocala 

Orlando 

Punta   Gorda 
Taltahaaaee 

Tampa 


.♦V,  B.  Lamounoi,  C  E. 
.     Fred   A.    5afny 
..    George  B.  Reed 
.    C.  A.   Holloway 

-  Russell    Brouehman 

-  C.  A,  Renney 
.  C.  N,  Hobbs 
.  0.  H.  O.burn 

"Assistant    Engineer 


PUBLIC  HEALTH  NURSES 


Lake  City. 

Ta  m  pn^ »— 

Arcadia... 


DeFuniak  Springs. 
Eden.  R.   F.   D.   Jensen- 
Lake   City 

M  a  di  son „ 

Mariiwss 

Rusk  in 


Starke.. 


_*Clio    McLaughlin,    R.    N. 
.•Harriet    I.  Sherman,  R,   N. 
,  Jule    Craves.    R.    N. 

Nanus   Colby.   R.   N. 

Sarah   Ida    Richards.   R.    N. 

Frances  Hall.  R.  N, 

Thora    Roberta,  R.  N. 

Elizabeth   Hi  ion.   R,   N, 

Joyce  Ely.  R.  N: 

Mary  C.   Dodd.   R.   N. 

'Field   Supervisor 


FLORIDA  STATE  BOARD  OF  HEALTH 35 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

THE  CIRCUS 

The  Staff  of  the  State  Board  of  Health  has  enjoyed  a  visit  from 
Mrs.  Walter  McNab  Miller  of  the  American  Child  Health  Association 
and  the  White  House  Conference  Committee, 

Mrs,  Miller  is  in  Florida  in  the  interest  of  organizing  a  State 
Health  Council  which  shall  cooperate  with  the  official  Health  Depart- 
ment and  actively  support  the  program  of  the  Health  Officer.  Mrs. 
Miller  has  manifested  a  keen  interest  in  the  screening  and  sanitary 
privy  demonstrations  which  will  be  made  in  the  western  portion  of  the 
State.  The  object  is  to  show  the  farmer  how  he  can,  at  a  low  cost, 
protect  himself  from  malaria  and  hookworm  infection.  At  this  demon- 
stration the  Bureau  of  Engineering  will  screen  and  paper  a  house  and 
build  a  "State  Board  of  Health  Sanitary  Privy"  without  expense  to  the 
farmer  where  this  is  done. 

The  Bureau  of  Communicable  Diseases  will  hold  an  immunization 
clinic  giving  typhoid  inoculations  and  toxin  antitoxin  (against  diph- 
theria) to  all  who  wish  to  take  advantage  of  the  opportunity  to  pro- 
tect themselves. 

The  Bureau  of  Child  Hygiene  and  Public  Health  Nursing  will  be 
present  to  examine  the  children  and  give  advice  to  mothers  in  the  care 
of  the  babies. 

The  Laboratories  will  have  representatives  there  to  show  how 
you  find  out  whether  you  have  hookworms  or  malaria  or  whether  your 
"blood  is  good,*' 

This  will  be  a  circus  with  barbecue,  moving  pictures  and 
everything  which  can  be  thought  of  to  improve  the  health  and  wealth 
of  the  State.  All  members  of  the  State  Board  of  Health  will  be  pre- 
sent. Governor  Carlton,  Mr.  Cawthon,  State  Superintendent  of  Edu- 
cation, President  Tigert  and  all  the  Governor's  Cabinet  will  be  invited 
to  attend  and  join  this  big  health  crusade.  A  moving  picture  will  be 
taken  of  activities. 

The  first  demonstration  will  take  place  in  Leon  County,  near 
Tallahassee  on  April   1  7  th. 

DRUG  STORES 

The  attention  of  all  druggists  is  invited  to  the  following. 

At  a  meeting  of  the  Board  of  Pharmacy  held  in  Gainesville,  Jan- 
uary   13-14,    1930,  the  following  rule  was  adopted: 

"Any  person  who  is  convicted  or  pleads  guilty  to  the  violation  of 
any  laws  pertaining  to  Pharmacy  in  the  State  of  Florida  shall  be  for- 
ever barred  from  taking  an  examination  or  reciprocating.  This  shall 
apply  to  both  proprietors  and  clerks." 

Passed  January  14,   1930. 

(Signed)  J.  H.  Haughton,  Secretary. 

Laws  governing  regulations  and  inspection  of  drug  stores.  Chapter 
11859  (No.  54)  Laws  of  1927  and  amended  as  in  Chapter  13757 
(No.    193)   approved  June  8,    1929,  charge  the  Drug  Store  Inspector, 

Special  Notice — Page  45 


36 FLORIDA  STATE  BOARD  OF  HEALTH 

ADMINISTRATION 

working  under  the  supervision  of  the  State  Board  of  Health,  with  duty 
"to  see  to  the  strict  and  proper  compliance  with  the  provisions  of  this 
act."  This  refers  to  the  provisions  of  the  law.  The  action  of  the  Board 
of  Pharmacy  quoted  above  is  independent  of  the  law  cited  and  is  in- 
tended to  aid  in  its  enforcement, 

ANNUAL  BOARD  MEETING 
The  State  Board  of  Health  met  in  regular  annual  meeting  in  the 
office  of  the  president  of  the  Board  at  200  E.  Forsyth  Street,  Jackson- 
ville, on  February  1  1,   1930, 

The  entire  Board,  consisting  of  Hon.  Chas.  H.  Mann,  president, 
H.  Mason  Smith.  M.  D.,  W.  D.  Nobles.  M.  D.  and  Henry  Hanson. 
M.  D.,  secretary  and  State  Health  Officer,  were  present. 

The  auditor  and  four  bureau  directors  were  invited  in  to  discuss 
special  topics  pertinent  to  their  respective  bureaus. 

At  this  meeting  the  contract  for  biologies  was  awarded  as  follows: 
1 .      Anti-rabic  virus  to  the  Medical  Arts  Laboratory,    the  Okla- 
homa Pasteur  Institute,   operating  under   U.    S.    Government   License 
No.  98. 

2.  Other  biologies,  such  as  diphtheria  antitoxin,  tetanus  antitoxin, 
anerobic  antitoxin  (gas  gangrene),  antimeningococcus  serum,  vaccine 
virus  (S.  P.),  Schick  test  material,  toxin  antitoxin  (diphtheria),  ty- 
phoid bacterin  (plain  and  triple)  to  E.  R.  Squibb  &  Company  of  New 
Brunswick,  N.  J. 

The  purchase  of  quinine,  carbon  tetrachloride  and  silver  nitrate 
will  be  from  H.  K.  Mulford  Company. 

The  manner  of  free  distribution  of  therapeutic  biologies  is  ex- 
plained in  the  State  Health  Officer's  letter  to  physicians  reproduced 
below, 

(Letter) 
BIOLOGICS  DISTRIBUTION 
Dear  Doctor: 

At  the  December  meeting  of  the  State  Board  of  Health  it  was 
decided  to  abandon  the  policy  of  the  free  distribution  of  therapeutic 
biological  products  save  for  administration  to  those  who  are  definitely 
unable  to  pay  for  them.  This  is  in  line  with  the  general  policy  of  the 
Board  to  confine  its  activities  to  prophylactic  measures  and  not  to 
enter  the  field  of  treatment.  All  physicians  understand  that  certain 
deviations  from  this  policy  as  in  the  case  of  hookworm  disease  and 
malaria  are  absolutely  necessary  for  the  time  being  but  will  be  discon- 
tinued as  soon  as  conditions  warrant. 

On  and  after  the  first  day  of  February,  therefore,  the  following 
items  ■will  be  furnished  only  to  physicians  who  will  agree  to  furnish 
for  each  package  of  therapeutic  serum  used  a  "Certificate  of  Indigency" 
on  the  form  provided  on  the  package. 

Diphtheria  Antitoxin,  1  0,000   units 

Diphtheria  Antitoxin,  5,000   units 

Tetanus  Antitoxin,  20,000   units 

Tetanus  Antitoxin,  1  0, 000   units 

Anerobic  Antitoxin,  10  c.  c.  package  (Gas  Gangrene) 

Anerobic  Antitoxin,  100  c.  c.  package   (Gas  Gangrene) 

Antimeningococcus  Serum,  30  c,  c.  package 

Are  You  Interested  in  Health  Notes — See  Page  45 


FLORIDA   STATE   BOARD   OF   HEALTH 37 

ADMINISTRATION 

The  1,500  unit  package  of  tetanus  antitoxin  is  regarded  as  a  pro- 
phylactic measure  and  will  be  furnished  free  for  all  cases. 

The  other  items  which  will  be  furnished  free  to  all  persons  without 
the  Certificate  of  Indigency  are: 

Vaccine  Virus  (Smallpox) 

Schick  test  material 

Carbon  tetrachloride  (Hookworm) 

Toxin  Antitoxin  (Diphtheria) 

Typhoid  bacterin  (plain  and  triple) 

In  addition  to  the  items  mentioned  on  this  list,  antirabic  virus 
will  be  furnished  without  charge,  but  it  will  be  necessary  in  each  in- 
stance for  the  Board  of  Health  to  know  the  name  of  the  patient  receiv- 
ing the  treatment  and  the  physician  administering  same. 

The  staff  of  the  laboratory,  which  is  charged  with  the  adminis- 
tration of  the  regulation,  will  be  grateful  for  your  cooperation. 

Respectfully,         Henry  Hanson, 

State  Health  Officer. 

STATE  CONFERENCE— SOCIAL  WORK 

The  Florida  State  Conference  of  Social  Work  will  be  held  in  Jack- 
sonville on  April  7th,  8th,  9th  and   10th,   1930. 

The  first  two  days  of  the  Conference  will  be  given  over  to  an 
Institute  which  will  offer  three  courses,  i.  e,,  Family  Case  Work,  Insti- 
tutional Administration  and  Child  Guidance. 

On  the  second  two  days  the  Conference  proper  will  be  held.  This 
program  has  been  developed  under  five  heads.  Dependency,  Delin- 
quency,  Leisure  Time  Problems,   Public  Health  and  Mental   Hygiene. 

A  consultant  service  of  those  conducting  the  Institute  will  be  avail- 
able,  by  appointment,   to  persons  who  desire  it. 

A  registration  fee  of  one  dollar  per  course  will  be  charged  to 
those  who  attend  the  Institute. 


BUREAU  OF  ENGINEERING 
Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

MOSQUITO  MEETING 

Once  again  our  Florida  Anti-Mosquito  Association  is  planning  to 
gather  and  renew  old  acquaintanceships,  gather  courage  for  the  season's 
mosquito  battle  and  learn  the  latest  tricks  discovered  to  keep  up  our 
eternal  warfare  on  the  pest  that  is  largely  responsible  for  Florida's  pres- 
ent economic  handicap  —  the  hordes  of  Taeniorhynchus  on  the 
coasts,  Mansonia  in  the  central  portion  and  Anopheles  in  the  north 
and  western  areas. 

Complete  the  Coupon  on  Page  45 


38 FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU  OF  ENGINEERING 

Sarasota  claims  the  meeting  this  year,  Sarasota  is  down  on  the 
west  coast  where  real  mosquito  control  work  is  just  beginning  to  get 
started.  Ft.  Pierce  had  it  last  year  and  for  next  year  the  bids  are  al- 
ready in  from  Perry,  up  in  the  malaria  section  of  the  State. 

April  second  and  third  are  the  meeting  dates  and  headquarters 
will  be  at  the  Hotel  El  Vernona.  Sessions  will  start  on  April  2nd  at 
9  a.  m.  Following  registration  and  the  regular  session  from  1  0  a.  m. 
to  I  2  :30  p.  m.,  there  will  be  a  luncheon  and  an  afternoon  round  table 
discussion  on,  "What  can  a  community  do  to  eliminate  Mosquitoes." 
In  the  evening  the  annual  banquet  will  be  held.  During  the  morning 
of  April  3rd,  a  general  discussion  on  "County-wide  Control  Problems" 
will  be  held,  which  will  be  followed  by  election  of  officers  and  ad- 
journment. 

Every  woman's  club  representative,  every  year-round  business 
man  in  Florida,  every  citizen  interested  in  the  progress  of  his  com- 
munity should  attend  the  sessions.  Plan  now  on  being  there:  a  worth- 
while meeting  is  guaranteed. ! 

•       WATER  WORKS  MEN.  -  ATTENTION  I 
ANNOUNCEMENT 

The  University  of  Florida  through  its  Extension  Division,  the 
Florida  State  Board  of  Health  and  the  Florida  Section  American  Water 
Works  Association  will  hold  a  four  day  short  course  on  Water  Purifica- 
tion and  Sewage  Treatment,  at  the  University  of  Florida,  Gainesville. 
April  8,  9,  10  and  11.- 

The  short  course  school  will  start  at  2  p.  m.,  on  the  afternoon 
of  the  8th  and  the  Fifth  Annual  Meeting  of  the  Florida  Section  Amer- 
ican Water  Works  Association  will  start  on  the  morning  of  the  1  0th. 
All  sessions  of  the  school  will  be  held  at  the  University  of  Florida, 
Department  of  Chemistry,  under  the  direction  of  Professor  A.  P.  Black 
and  will  consist  of  lectures,  tests  and  demonstrations  on  water  works 
and  sewage  problems,  especially  those  relating  to  chlorination,  coag- 
ulation, bacterial  control  and  pumping  problems.  Registration  for  the 
school  should  be  made  now. 

The  headquarters  for  those  in  attendance  at  the  school  and  meet- 
ing will  be  the  Hotel  Thomas  at  Gainesville  and  hotel  reservations 
should  be  made  promptly. 

A  faculty  of  men  from  all  parts  of  the  country  will  be  present 
and  water  works  men  of  Cuba  have  been  invited  to  attend. 

The  Florida  Section  American  Water  Works  Association  will  ap- 
preciate your  giving  this  matter  the  widest  publicity  possible.  The 
program  will  be  issued  later  and  information  may  be  obtained  from 
this  Bureau,  care  of  the  State  Board  of  Health,  Jacksonville,  Fla. 

See  Notice  of  Mailing  List  Revision — Page  45 


FLORIDA  STATE  BOARD  OF  HEALTH 39 

BUREAU  OF  CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 
Clio  McLaughlin,  R.  N.,  Field  Supervisor 

MAY  DAY 

The  year's  at  the  Spring, 
The   day's  at   the   morn, 
Morning's  at  seven, 
The  hillside's  dew-pearled. 
The  lark's  on  the  wing. 
The  snail's  in  the  thorn; 
God's  in  his  heaven. 
All's  right  with  the  world. 

— Browning. 

When  any  of  us  read  the  above  lines,  we  usually  have  a  feeling  of 
satisfaction  and  happiness,  the  idea  that  spring  is  with  us  and  all  is 
well.  It  is  spring  that  brings  the  budding  of  trees  and  flowers.  The 
grass  grows  more  rapidly  and  is  greener,  fruits  ripen,  and  everything 
takes  on  new  life.  It  is  for  this  reason  that  Mr.  Hoover  has  chosen 
May  1st  as  Every  Child's  Day — May  Day,  that  all  may  be  happy  and 
rejoicing,  that  it  may  be  a  day  of  gladness  for  everyone,  grownups  as 
well  as  children  since  all  of  us  have  our  share  in  this  Celebration. 

The  daisy  has  been  chosen  as  emblematic  of  May  Day  as  it  sig- 
nifies innocence  and  power.  The  snow-white  petals  indicate  innocence 
and  the  bright  yellow  center,  success.  It  is  for  happiness,  efficiency, 
and  success  that  we  are  striving  today.  We  are  striving  for  strong, 
stalwart,  straight  thinking  men  and  women,  and  only  by  laying  a  firm 
foundation  can  this  be  obtained. 

We  must  yield  to  our  children  their  birthright — health  and  edu- 
cation. By  staying  in  the  sunshine,  playing  active  games,  and  mingling 
with  others,  children  develop  good,  strong  bodies  and  good,  clean 
minds.  Growing  minds  must  be  kept  busy  with  something  and  if  they 
are  not  guided  in  the  right  direction,  then  they,  without  doubt,  turn  to 
the  wrong,  which  usually  results  in  degeneracy  and  crime. 

In  order  to  promote  a  nation-wide  interest  in  Every  Child's  Day, 
we  are  organizing  a  Child  Health  Council,  similar  to  those  in  other 
states,  upon  which  every  state- wide  organization,  official  or  voluntary, 
will  have  a  representative.  This  is  a  national  organization  and  is  an 
affair  in  which  everyone  must  take  part.  Parents  are  most  important 
in  the  celebration  of  May  Day,  for  without  right-thinking,  happy  par- 
ents, we  do  not  get  well-reared,  happy  children.  A  worth  while  indi- 
vidual means  a  help  to  his  town,  state,  and  community.  So  with  the 
brains,  work,  and  money,  all  of  which  we  have  in  abundance  in  the 

state,  let's  all  work  together  to  organize  the  Child  Health  Council. 

s 

Each  nurse  on  the  staff  of  the  State  Board  of  Health  is  out  in  her 

district,  working  in  the  interest  of  May  Day,  so  that  every  man,  woman 

and  child  may  know  the  significance  of  the  words  and  make  May  Day 

a  year-round  celebration. 

Important  Notice — Page  45 


I 


40 f     FLORIDA    STATE   BOARD    OF   HEALTH __ 

BUREAU  OF  DIAGNOSTIC  LABORATORIES 
Paul  Eaton,  M.  D.,  D.  P.  H.t  Director 

THE  FUNCTION  OF  A  STATE  LABORATORY 

It  is  through  the  Laboratory  that  the  State  Board  of  Health  has 
its  most  direct  contact  with  the  medical  profession.  Other  depart- 
ments usually  ask  the  physician  for  something.  The  State  Laboratory 
offers  to  give  him  something.  That  is  to  say,  service.  In  the  early 
days  of  bacteriology,  it  was  necessary  for  organized  bodies  such  as 
health  departments,  state  and  city,  because  of  the  lack  of  private  la- 
boratories, to  provide  laboratory  facilities  for  the  profession  at  large. 
That  this  is  true  is  shown  by  the  fact  that  so  many  laboratories  in  the 
early  days  did  tissue  work,  which  has  not  been  considered  for  some 
years  to  be  a  legitimate  function  of  a  state  laboratory.  It  may  be  men- 
tioned, however,  that  at  the  present  time  there  is  a  movement  back 
to  the  early  custom  in  this  respect. 

The  earliest  services  offered  to  the  profession  were  the  diagnosis 
by  microscopic  methods  of  diphtheria  and  tuberculosis.  As  medical 
science  progressed,  the  diagnosis  of  malaria,  gonorrhea  and  certain 
other  conditions  were  added  to  this  list.  When  the  Wassermann  test 
was  first  offered  to  the  profession,  since  it  was  necessary  for  it  to  be 
done  in  a  well-equipped  laboratory,  it  was  generally  done  by  the  state 
laboratories  although  it  does  not  strictly  belong  to  preventive  medicine. 
The  same  may  be  said  of  its  successor,  the  Kahn  test,  which  is  done  in 
our  laboratory.  From  a  logical  standpoint,  the  diagnosis  of  syphilis,  by 
means  or  a  dark  field  examination,  belongs  much  more  properly  to 
preventive  medicine  than  does  the  serum  test,  but  it  will  be  impossi- 
ble for  state  laboratories  to  abandon  the  Wassermann  test  or  some  of 
its  substitutes. 

The  laboratories  of  the  State  Board  of  Health  of  Florida  have 
done  a  prodigious  amount  of  work  in  addition  to  the  serum  test  for 
syphilis.  There  are  serum  tests  for  typhoid,  para-typhoid,  typhus 
fever,  Brill's  disease,  undulant  fever  and  tularemia.  Microscopic  tests 
for  tuberculosis,  diphtheria,  malaria,  gonorrhea,  rabies,  and  hookworm, 
as  well  as  other  animal  parasites  added,  bring  up  the  total  to  almost 
100,000  tests  a  year  in  the  central  laboratory  at  Jacksonville.  The 
branch  laboratories  have  done  a  large  amount  of  work  which  has  been 
as  varied  in  its  character  as  the  work  done  in  the  central  laboratory. 
The  removal  of  the  Bureau  of  Vital  Statistics  from  the  central  building 
to  the  Florida  Theatre  Building  has  made  available  one  half  of  the 
space  on  the  first  floor  of  the  building,  most  of  which  has  been  given 
to  the  laboratory.  It  is  being  fitted  for  laboratory  purposes  so  that 
the  work  may  be  done  in  the  most  convenient  manner  possible.  By 
the  time  another  number  of  Health  Notes  appears,  we  will  be  able  to 
report  on  the  use  of  the  new  space. 

In  addition  to  the  routine  tests  which  we  have  mentioned,  a  state 
laboratory  ought  to  be  prepared  to  do  a  certain  amount  of  research  on 
new  and  imperfectly  understood  conditions  as  well  as  on  certain  prob- 
lems which  concern  our  state  more  than    other    states.       In  the    first 

"Health  Notes"  will  arrive  regularly  if  you  complete  coupon 

Page  45 


FLORIDA    STATE   BOARD    OF   HEALTH 


41 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 

class,  we  might  refer  to  the  disease  which  has  been  called  psittacosis 
which  has  been  the  subject  of  a  great  deal  of  newspaper  notoriety  with- 
in the  past  few  weeks.  Little  is  known  about  psittacosis  although  much 
has  been  written.  There  is  even  considerable  doubt  as  to  whether  the 
bacillus  psittacosis  differs  from  certain  other  bacteria  which  have  been 
more  thoroughly  studied.  Although  a  state  laboratory  cannot  be  ex- 
pected to  go  into  research  in  the  same  way  in  which  privately  endowed 
laboratories  might,  it  ought  to  be  so  equipped  and  staffed  as  to  make 
it  possible  to  do  some  'work  of  this  kind. 

From  another  standpoint,  the  state  laboratory  should  be  used  in 
some  way  as  an  educational  center.  Whether  or  not  it  would  be  possi- 
ble to  have  a  formal  connection  with  the  State  University  and  thus 
train  Florida  students  for  this  kind  of  work  remains  to  be  seen.  An 
effort  is  being  made  in  this  direction.  There  is  no  reason  why  Florida 
students  should  have  to  go  outside  of  the  borders  of  their  own  state 
to  become  thoroughly  proficient  in  public  health  laboratory  methods. 

SUMMARY   OF   WORK    DONE    IN   THE   LABORATORIES   OF 


-IE  STATE  BOARD  OF 

Jacksonville 


HEALTH.  JANUARY,  1930 

Tampa      Pen » cola     Miami     Tatlahauee     Total 


Animal  Parasites 

Diphtheria    

Typhoid 

Malaria 

Rabies  


Tuberculosis 
Gonorrhea 

Kahn    ___.„ 

Water:  Count  „ 
Water:  Colon  .. 
Milk:  Bacterial 
Milk:  Chemical 
Miscellaneous   ... 


Exam. 
Exam. 


2202 
504 
362 
964 
24 
252 
392 

3356 


96 
127 
216 


853 

175 

137 

139 

3 

101 

160 

1769 

36 

161 

181 

43 


98 
66 
10 
12 

9 
31 


100 

102 

24 


272 
174 

41 

17 
1 

60 
153 
651 

91 
111 
291 

82 
444 


333 
41 
42 
99 

13 
42 

1 

1 

22 

20 

128 


8495  3778   452  2388 
Specimen  Containers  Distributed _ „ „_ 

BIOLOGICAL  PRODUCTS  DISTRIBUTED 


742 


3758 
960 
■592 

1231 

28 

435 

778 

5776 
128 
112 
690 
512 
855 

15855 
.8456 


Diphtheria  Antitoxin. 

Toxin  Antitoxin 

r  Schick 

Tetanus  Antitoxin 


Anaerobic  Antitoxin. 
Typhoid  Vaccine 


10.000 
5,000 


20.000 

1 0,000 

1.500 

100 

10 


units 
units 


units 
units 

units 


c. 


Vaccine  Virus.. 

Antirabic  Virus 

Antimeningocoecus  Serur 
Carbon  Tetrachloride 


178 

66 

14940 

4950 

25 

22 

1243 

3 

11 

2410 

5150 

36 

3 

2237 


Packages 
Packages 

C.  c. 

Tests 

Packages 

Packages 

Packages 

Packages 

Packages 

Treatments 

Capillaries 

Treatments 

Cylinders 

Capsules 


Get  Your  Name  on  Revised  Mailing  List — See  Page  45 


42 FLORIDA    STATE    BOARD    OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M  D.,  Director 

HEALTH  PICTURES 

Everywhere  the  State  Healthmobile  goes  there  is  an  enthusiastic 
response.  The  children  report  that  the  "show"  is  well  worth  going  to 
see.  The  teachers  report  an  increased  and  more  intelligent  interest 
in  health  studies  and  more  careful  observance  of  the  rules  of  hygiene. 
Why  should  it  not  be  so?  If  we  adults  enjoy  our  world  news,  the 
latest  novel  or  a  good  comedy  on  the  screen  more  than  we  would  in 
print,  then  we  must  expect  our  youth  to  want  their  health  ideas  gar- 
nished and  embellished  with  comedy  and  human  interest.  This  has 
been  done  in  the  health  films. 

Interesting  Movies 

"The  Garden  of  Childhood*'  shows  the  normal  play  and  work  of 
the  growing  child,  the  happiness  to  be  gained  by  developing  good 
habits. 

"Tommy  Tucker's  Tooth'"  deals  with  two  boyhood  playmates  and 
advantages  gained  by  one  over  the  other  largely  because  he  used  his 
toothbrush.  This  picture  shows  the  scientific  method  of  cleaning  the 
teeth,  the  reason  for  doing  it  and  the  results  of  neglect. 

There  is  a  picture  called  "Life's  Windows."  It  reveals  the  similarity 
between  the  eye  and  a  camera,  explains  why  some  people  do  not  see 
clearly  and  lets  us  into  the  secrets  of  better  vision  through  the  use  of 
properly  fitted  glasses. 

Then  there  are  films  that  deal  with  malaria  and  expose  the  dark 
and  villainous  life  of  the  mosquito  with  dagger-like  lance,  blood  suck- 
ing hypodermic  needle  and  connected  poison  gland  containing,  per- 
haps, the  deadly  germs  of  "Chills  and  Fever," 

The  hookworm  and  diphtheria  pictures  show,  graphically,  the  life 
of  the  agents  causing  those  diseases,  also  the  methods  and  great  bene- 
fits of  prevention  and  cure. 

There  are  other  health  pictures  but  these  are  the  most  popular. 

How  to  Get  the  Health  Show 
If  the  Healthmobile  has  not  recently  visited  your  county  we  ■will 
be  glad  to  date  it  up  for  a  week.  Your  County  Superintendent  is  best 
able  to  help  procure  the  service  because  the  pictures  are  shown  mostly 
to  school  children,  their  parents  and  friends  and  the  best  place  to  come 
together,  we  find,  is  usually  right  in  the  schoolhouse.  It  is  advisable 
to  get  in  your  application  early,  get  the  thing  talked  about  a  good  deal 
in  the  schools  and  local  papers  and  let  everybody  know  about  what 
a  treat  there  is  in  store  for  them. 

TOXOID 
Through  the  courtesy  of  the  Lederle  Antitoxin  Laboratories,  the 
State  Board  of  Health  has  received  a  supply  of  diphtheria  toxoid  suf- 
ficient for  the  treatment  of  950  children.  This  is  to  be  used  in  a  limit- 
ed area  for  the  immunization  of  children  from  one  to  six  years  of  age. 
Toxoid  is  given  in  the  same  way  and  for  the  same  purpose  as  toxin- 
antitoxin.  Two  injections  are  reported  to  immunize  about  the  same 
per  cent  of  children  as  three  of  toxin -anti  toxin  and  the  immunity  de- 
velops a  little  more  rapidly. 

Health  Notes  are  yours  for  the  asking — Page  45 


FLORIDA  STATE  BOARD  OF  HEALTH 43 

BUREAU  OF  COMMUNICABLE  DISEASES 

LOOKING  BACKWARD  OVER  FIFTY  YEARS  OF  HEALTH 
WORK  IN  FLORIDA.     (A  Review) 

Joseph  Y.  Porter  was  born  in  Key  West  in  1847,  graduated  from 
Jefferson  Medical  College  in  1870,  entered  the  Army  the  same  year 
where  he  served  until  1  889  when  he  became  the  first  State  Health  Of- 
ficer of  Florida.  He  held  this  position  for  28  years,  resigning  to  resume 
active  military  duty  in  the  World  War.  He  died  in  Key  West  in  March, 
1927.  No  history  of  public  health  in  Florida  can  ever  be  written 
without  giving  liberal  recognition  to  the  outstanding  service  of  Dr. 
Porter. 

Beginning  in  the  July,  1925,  issue  of  the  Journal  of  the  Florida 
Medical  Association,  there  was  published  serially,  an  article  by  Dr. 
Porter  under  the  above  title.  The  following  review  for  Florida  Health 
Notes  is  necessarily  condensed  and  even  more  sketchy  than  the  ori- 
ginal article. 

Neither  the  Constitution  of  1838  nor  that  of  1868  made  any  pro- 
vision for  protection  of  public  health  but  in  the  present  Constitution, 
ratified  in  1  886,  provision  was  made  for  "suppression  of  disease  aris- 
ing within  or  without  the  State."  This  was  due  to  the  insistence  of 
Dr.  John  P.  Wall,  a  member  of  the  Convention  from  Tampa.  Dr. 
Wall  was  a  native  of  Hamilton  County.  The  legislature  of  1  887  failed 
to  make  provision  for  carrying  out  this  part  of  the  Constitution. 

In  the  campaign  of  1 888,  Francis  P.  Flemming  was  a  candidate 
for  Governor.  During  his  campaign  he  came  to  realize  the  difficulties 
of  travel  occasioned  by  the  efforts  to  control  yellow  fever,  which  was 
epidemic  that  year.  County  Boards  of  Health  had  ample  authority. 
Travelers  were  often  stopped  and  sometimes  turned  back  because  the 
infection  of  yellow  fever  might  lie  hidden  about  their  clothing.  "Shot 
gun  quarantine"  was  maintained  by  one  county  against  another  and 
armed  guards  were  wont  to  impose  restrictions  we  now  know  to  have 
been  useless.  For  example,  flat  cars  of  iron  rails  and  a  box  car  of  ice 
■were  held  up.  Dr.  Porter  having  been  in  contact  with  yellow  fever 
patients  was  informed  that  he  would  be  shot  at  if  he  attempted  to  go 
from  Jacksonville  on  an  engine  to  visit  the  sick  in  a  community  south 
of  Baldwin.  Thus  it  was  that  Governor  Flemming's  first  official  act  was 
to  call  a  special  session  of  the  legislature  and  get  laws  enacted  pro- 
viding for  a  State  Board  of  Health,  It  was  not.  however,  until  the 
regular  session  of  1 889  that  the  first  board  was  appointed  and  Dr. 
Porter  was  selected  as  the  first  State  Health  Officer.  This  provision 
for  protection  to  life  and  health  is  referred  to  as  being  essential  to  the 
development  of  the  State's  resources  and  to  the  welfare  of  her  citizens. 
It  was  during  this  yellow  fever  epidemic  of  1  888  that  Dr.  Joseph 
Y.  Porter  had  been  placed  in  charge  of  the  Government  Relief  Service 
at  Jacksonville  where  the  municipal  government  and  business  affairs 
had  become  disorganized  and  conditions  in  general  were  serious.  Pres- 
ident Cleveland  had  authorized  an  expenditure  of  $50,000.00  from 
a  government  emergency  relief  fund.  Large  donations  came  in  from 
all  parts  of  the  United  States  and  the  Relief  Service  was  thus  enabled 
to  do  its  work  well.  Under  the  direction  of  Dr.  Porter,  every  house 
in  Jacksonville  was  fumigated.     The  details  of  this  task  were  carried 

See  Important  Notice — Page  45 


44 FLORIDA    STATC   BOARD    OF    HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

out  by  Dr.  D.  M.  Eschemendia  of  Jacksonville  and  to  this  procedure 
is  attributed  the  non-return  of  yellow  fever  to  Jacksonville  the  follow- 
ing summer,  This  was  ten  years  before  the  investigations  of  Reed  and 
his  associates  had  demonstrated  the  part  played  by  the  mosquito  in 
the  transmission  of  yellow  fever. 

After  the  epidemic  and  when  conditions  became  normal  a  meet- 
ing was  called  and  tribute  paid  to  the  many  who  had  served  so  valiant- 
ly. To  Dr.  Porter  was  presented  a  beautiful  gold  watch,  chain  and  fob 
which  have  now  passed  to  his  son  to  be  handed  down  by  him  to  suc- 
ceeding generations. 

The  foregoing  makes  it  clear  enough  why,  at  a  time  when  the  con- 
trol of  yellow  fever  was  the  paramount  health  problem.  Dr.  Porter  was 
selected  by  Governor  Flemming  to  be  the  first  State  Health  Officer. 

The  chief  concern  of  the  State  Board  of  Health  then  was  to  pre- 
vent contagious  diseases  entering  the  State  by  way  of  the  sea.  Trie 
greatest  danger  was  that  yellow  fever  might  again  be  introduced  from 
Cuba.  With  no  precedent  or  guide  to  follow  save  those  of  the  Monroe 
and  Escambia  County  Boards  of  Health,  the  task  was  a  difficult  one. 
The  seaboard  counties,  through  their  local  boards  had  maintained  a 
maritime  quarantine  and  boarded  vessels  entering  the  several  ports 
during  the  summer  for  the  purpose  of  keeping  out  all  individuals  who 
might  bring  infection. 

As  soon  as  possible  the  new  State  Board  of  Health  built  quaran- 
tine stations  at  Pensacola,  Tampa,  Key  West  and  Fernandina.  These 
were  equipped  with  the  most  modern  machinery  for  disinfecting  per- 
sonal effects  and  fumigating  ships  and  their  cargoes.  By  act  of 
Legislature,  these  stations  were  sold  in  1901  to  the  United  States  and 
operated  by  the  Marine  Hospital  service  (now  known  as  the  U,  S. 
Public  Health  Service) .  The  State  quarantine  officials  were  accepted 
as  federal  civil  service  employees. 

The  Monroe  County  Board  of  Health  in  1  886  had  permitted  sum- 
mer travel  from  Cuba  if  the  crew  and  passengers  of  ships  entering  port 
had  certificates  to  show  that  they  were  immune  by  virtue  of  having  had 
yellow  fever.  Under  similar  restrictions  travel  between  Havana  and 
Tampa  was  permitted  in  the  summer  of  1887.  The  new  State  Board  of 
Health  after  a  conference  of  representatives  from  the  principal  cities 
and  counties  on  the  coast  and  along  the  railway,  adopted  the  Monroe 
County  plan  and  permitted  travel  under  the  "immune  card"  system. 

It  was  gratifying  to  Dr.  Porter  when,  in  1  893  the  Surgeon  Gen- 
eral called  a  conference  of  health  officers  from  seaboard  States  and 
Cities  and  the  principles  of  marine  sanitation  of  the  State  Board  of 
Health  of  Florida  were  approved  and  with  but  slight  change  made  a 
part  of  the  national  quarantine  law. 

Shortly  after  the  organization  of  the  State  Board  of  Health,  the 
State  was  divided  into  districts  and  a  medical  man  appointed  as  assis- 
tant for  each  of  these  districts.  Most  often  one  county  constituted  a 
district.  These  assistants  were  paid  a  per  diem  and  expenses  when 
away  from  home.  The  next  step  was  the  selection  of  district  nurses 
to  look  after  tuberculous  patients  and  give  instructions  on  prenatal  care 
and  child  welfare. 

(To  be  continued  next  month) 

Don't  Miss  the  Next  Issues  of  Health  Notes — See  Page  45 


I-   FLORIDA 


FLORIDA  STATE  BOARD  OF  HEALTH 45 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

_      DEATHS— AGE  GROUP   1-4 

As  this  copy  of  the  Health  Notes  goes  to  press, 
last  year's  mortality  figures  arc  not  available.  Be- 
fore taking  up  results  obtained  from  tabulations  of 
the  1929  records,  it  has  been  deemed  advisable  to 
publish  one  more  study  of  deaths  by  causes  in  a 
specific  age  group.  One  publication  covered  ages 
20  to  59,  inclusive;  another  15  to  19,  inclusive:  and  a  third.  20  to  24, 
inclusive.  A  number  of  requests  have  been  received  for  the  percentage 
of  deaths  from  leading  causes  in  a  pre-school  age  group.  The  two 
charts  which  follow  ■were,  therefore,  prepared  for  age  group  I  to  4, 
inclusive,  by  color  and  by  sex  for  the  ten  leading  causes  of  death — 
1  928.  The  same  information  will  undoubtedly  appear  at  a  future  date 
for  the  calendar  year  1929. 

NOTICE  TO  LOCAL  REGISTRARS 

The  signature  of  the  undertaker  or  person  acting  as  undertaker 
is  very  important.  Where  there  is  no  regular  undertaker  or  funeral 
director  in  charge,  the  signature  of  the  person  who  acted  as  undertaker 
should  appear  on  the  death  certificate.  The  word  "None"  should 
never  appear  in  the  space  provided  for  the  name  of  the  undertaker 
or  person  who  acted  as  such.  When  a  body  is  interred,  there  is  always 
someone  who  does  the  work.  It  is,  therefore,  improper  to  make  a 
statement  on  the  death  certificate  to  the  effect  that  there  is  no  one  act- 
ing as  undertaker.  This  part  of  a  death  certificate  is  very  important 
and  is  very  often  information  quite  necessary  in  adjusting  estates,  etc. 

Please  watch  the  certificates  coming  through  your  office  and  see 
that  there  is  always  a  signature  under  item  1 9  which  is  provided  for  the 
name  and  address  of  the  undertaker  or  person  acting  as  undertaker. 


REVISION   OF   MAILING  LIST 

Persons  who  desire  to  continue  receiving  Florida  Health  Notes 
are  requested  to  fill  in  and  return  this  form  promptly. 


Health  Notes, 

State  Board  of  Health,  I    desire    to    continue  receiving 

Jacksonville,  Florida.  Florida  Health  Notes. 

Name    

Official  Title,  if  any 

Street  or  R.  F.  D.  No _ '. :.™ 


Post  Office „ -„ State., 


46 


FLORIDA    STATE   BOARD    OF    HEALTH 


BUREAU    OF    VITAL    STATISTICS 

Leading  Causes  of  Death  in  Age  Group   1-4,  by  Sex, 
Florida,  White  Population — 1928. 


TOTAL  VIHITS 

MB 

EKltLB 

Diarrhea  sod  Enteritis    23  % 

Diarrhea  and  Enteritis     It  % 

Diarrhea  and  Enteritis     »7  # 

Pneunocia     11  i> 
(all  To  cms) 

Pneumonia     10  £ 
[all  fonna) 

Diphtheria  and  Croup    9  $ 

Influenza    9  % 
(all  fomsj 

Diphtheria  and  Croup     6  Jo 

Pneumonia     6  ^ 
[all  forma! 

Diphtheria  end  Croup     6  % 

Influenza    6  $ 
(all  forma) 

Malaria     7  JS    * 

Valeria     6  £ 

llalerl  j     e  % 

Accidental  Drowning     6  5o 

Other  General  Diseases     4  % 

Accidental  Drowning     4  # 

Influenza     4  JJ 
(all  forma) 

Other  General  31  a  ease  a     3  $ 

Autcenobile  Accidents     3  j;i 

Intestinal  Oastructiona     4  % 

Autonoblle  Accidents    3  £ 

Poisoning  oy  Food     2  # 

Other  Acute  Poisonings     2  £ 

Intestinal  Obstruction     3  £ 

Accidental  Ci-ownlng     3  # 

Nephritis     £  £ 

Nephritis     £  % 

Autanohil.9  Accidents     3  $> 

nephritis    2  % 

Important  Notice — Page  45 


FLORIDA    STATE   BOARD    OF   HEALTH 


47 


BUREAU  OF  VITAL  STATISTICS 

Leading  Causes  of  Death  in  Age  Group    1  -4,  by  Sex, 
Florida,  Colored  Population — 1928. 


TOTAL  COLORED 

M22 

TE-JX 

Pneumonia      19  £ 
(all  tsms) 

Diarrhea  and  "nteritia    21  ? 

pneumonia     19  % 
(all  forma) 

Diarrhea  and  IMterltle     17  % 

Diarrhea  and  Lnterltle     12  % 

FEeunoiii:;     EOJ 
(all  forms) 

Isfluanzi     11  % 
{ell  forme) 

Influenza     S  # 
(all  tons) 

Influenza     7  Jf 
(all  foma) 

Accidental  Durae     6  £ 

Ace  id  ante  L   3uma      5  $ 

Accidental  3urns     4  % 

Malaria     4  % 

Malaria     4  * 

Automobile  Accidents     4  % 

Diphtheria  end  Croup     4  £ 

Diphtheria  and  Croup     4  'f, 

Malnrl-     3  j6 

Accidental  Draining     4  % 

Accidental  Drowning      3  % 

Diphtheria  er.d  Croup     3  % 

whooping  Cough     3  % 

Whooping  Cough      2  % 

Tuberculosis  |cll  forma}    3  % 

rubereuloaie   (all  ronns)     E  56 

Tetanus     2  % 

AutCEobile  Accidents     E  ^ 

Syphllla     3  % 

Tubereuloeia   (all  ronsa)      E  % 

Accidental  Drowning     3  £ 

To  Receive  Health  Note8  Regularly — See  Page  45 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 

THE  WORMY^WAY 

Problem,  in  MultiplicatioiL 

HOOKWORM    INFESTATION 

40  Worms  in  each,  person,. 
9.000  Eggs  laid  daily  by  1  woxm 
360.000  Eggs  deposited  daily  by  1  person. 
1440. 000  Eggs  deposited  daily  by  one  family  of  four. 

HOOKWORM   DISEASE 

200  Warms  ia  each,  person. 

9,000  Eggs  laid  daily  by  1  worm. 

1,800.000  Eggs  deposited  dairy  by  1  person 

7.200,000  Egg's  deposited  daily  by  one  family  of  txir. 


Eggs  under  normal  conditions  d 
soil  and  temperature  develop  into 
infective  larvae  in  120  hours. 

larvae  may  live  3  months  but  due 
to  unfavorable  conditions  in  nature 
this  cycle  Is  reduced  to  an  avecags 
of  about  3  weeks. 


Problem  Erased  by 


State  Board  of  Health  Sanitary  Privy. 


Did  You  Complete  Coupon? — Page  45 


This  Issue  Exceeds  1  1 .000  Copit 


frt.ORIDA 


AlTOof 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED  JULY,    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  as  Second   Class   Mutter,  October  27.    1921 
■  I  the   Pcntoffiee  at   Jacksonville.    Florida,   Under  the  Act   of  August    24,    1912 

"This  Bulletin  will  be  sent  to  any  address  in  the  State   free  of  charge. 

Vol.  22  APRIL,  1930  No.  4 


Edited    by 

STEWART  G.  THOMPSON,  D.P.H.,  Member 
American   Medical   Editors*  and  Authors'   Assn. 


HEALTH  NEWS  —  Hanson 

LABORATORY  NOTES  —  Eaton 

THE  HEALTH  COUNCIL  —  Blachly 

COUNTY    HEALTH    SERVICE  —  Brink 

MARRIAGES    AND    DIVORCES  —  Thompson 


HENRY  HANSON,  M.  D.,  STATE  HEALTH  OFFICER 


50 


FLORIDA    STATE    BOARD    OF   HEALTH 


Chas.    H.    Mann.    Pres. 
Jacksonville 


BOARD    MEMBERS 

H.    Mason    Smith.    M.    D. 

Tampa 


Wm.   D.   Nobles.  M.  D. 
Pensacola 


STATE  HEALTH  OFFICER 

Henry   Hanson,    M.    D. 

BUREAUS  AT  JACKSONVILLE  DIRECTORS 


Diagnostic    Laboratories.. 
■Vital    Statistics. 


Communicable   Diseases- 
Engineering.. 


Paul    Eaton.    M.    D..  D.    P.    H. 
Stewart  G.  Thompson.   D.  P. 


F,  A.  Brink,  M.  D. 

Ellsworth   L.   Filby.  C  -E. 

Child   Hygiene   and   Public   Health   Nursing Lucile    Spire    Blachly,    M.    D. 

Accounting ,,  „,     ■  ■ — —  Screven   Doiier 

Crippled   Children F.    L.   Fort,   M.  D. 


"550  Local  Registrars    (County  Mat  furnished  on  request). 

•Registration     Inspector — „___ — _ Anna  C.  Emmons 

Drug  Store    \nmp*rinr  „ H.  R.  Monroe 

Drug   Store    Inspector.™™ W.   A.   Mahoney 


LABORATORIES 


Jacksonville 

Miami 

Pensa  cola. 

Tall  alia 

Tampa.. 


Pearl    Griffith,    B.    E. 


—   E.   R.    Powell 

Jnnie   B.    Currie,    B.    3. 

Elizabeth    Byrd.    B.   S. 

H.  D.  Venters.  B.  S. 


MEDICAL   OFFICERS 


DrFunink    Spring* 

Jack  Hon  v  i  U« 

Melbourne 

Quin  c  y . 

Tallahassee  ,.,. 

Ta  m  pa 


C    W.    McDonald,    M.    D. 
B.  C.   Wilson,   M.  0, 
W     A.    Ciailon,   M,    D. 
A.  C.   Hamhlin.   M-   D. 
A.   P.  Harrison.  M.  D. 
Chas.   W,   Pease,   M.  D 


DISTRICT    SANITARY    OFFICERS 


Tampa,, 


Jacksonville. 

Miami . 

Ocata 


Orlando. 
Punta  Gorda  .. 
Tallahassee 
Tampa.... 


•V.  B+  Lamoureui,  C.  E. 

Fred   A-  Safay 

George    B.    Reed 

C.  A.   HoJIoway 

Russell    B  rough  man 

G,  A.  Renney 

C  N.  Hobbs 
„    D.  H.  OibuiD 
*  A  a  sista  n  t    En  gi  n  eer 


PUBLIC   HEALTH   NURSES 


Lake   City._ 
Tampa 

Arcadla- 


DeFuniak    Springs ....__..._.. 
Eden,   R.    F.   D.   Jensen . 

Lake    City— 

Madison * 

Ruskin 

Blurtn-  „      


.  "Clio    McLaushlin,    R.    N. 

.•Harriet     F.    Sherman,    R.    N. 

....  Jule  Graves,   R.   N. 

...   Nanna    Colby.    R.    N. 

...  Sarah   Ida    Richards.   R.   N. 

....  Frances  Hall,  R.  N 

...  Thora   Roberts.   H.  N. 

_  Joyce  Ely.  R.   N. 

_    Mary   G.   Dodd,   R.   N. 

•Field   Supervisor 


FLORIDA  STATE  BOARD  OF  HEALTH 


ADMINISTRATION 
Henry  Hanson,  M.  D,,  State  Health  Officer 

HEALTH  NEWS 

The  United  States  Public  Health  Service's  "Health  News"  M-3  I  7. 
in  comparing  communicable  disease  prevalence  for  the  week  ending 
February  26,  1930,  with  that  of  the  week  ending  February  23,  1929, 
shows  diphtheria  and  poliomyelitis  still  slightly  dropping  but  depicts 
a  general  increase  in  measles,  meningitis,  scarlet  fever  and  smallpox. 
The  above  is  based  on  reports  received  from  forty-six  (46)  states  and 
ninety-six  (96)  cities. 

We  know  quite  conclusively  how  the  communicable  diseases  are 
transmitted  from  one  person  to  another  in  all  except  smallpox.  We 
know  it  to  be  through  secretion  from  the  nose  or  throat.  If  perfect 
cleanliness  were  observed,  if  those  who  attended  the  sick  washed  their 
hands,  scalded  the  dishes  and  gathered  up  all  the  soiled  rags,  or  what- 
ever material  is  used  to  receive  the  nasal  or  throat  secretions,  there 
would  be  no  spread  of  such  diseases.  The  soiled  articles  should  be 
wrapped  in  a  paper  and  burned  either  in  a  furnace  or  other  adequate 
cremating  apparatus.  It  is  very  unlikely  that  there  would  be  any  spread 
of  these  diseases  if  those  in  attendance,  or  who  contact  the  sick, 
would  always  remember  the  importance  of  the  use  of  soap  and  water 
after  such  contact. 

The  increase  in  smallpox  simply  illustrates  the  fact  that  there 
are  still  some  people  in  this  country  who  prefer  to  have  smallpox. 
When  this  group  decide  that  they  no  longer  want  this  disease  it  will 
disappear. 

MALARIA  IN  THE   UNITED   STATES 

"In  connection  with  field  investigations  relating  to  public  health 
problems,  the  U.  S.  Public  Health  Service  points  out  that  malaria  was 
once  prevalent  in  the  northern  United  States.  During  the  past 
50  or  60  years  it  has  greatly  diminished  and  is  no  longer  a  serious 
problem  there.  In  the  Southern  States,  malaria  has  also  decreased, 
but  in  many  localities  the  rate  is  still  high  and  constitutes  an  important 
sanitary  problem. 

"The  liability  of  a  serious  increase  of  malaria  in  the  North  is  not 
great  so  long  as  the  present  economic  status  of  that  region  persists; 
in  the  South  the  danger  of  recrudescence  of  the  disease  is  much  greater, 
as  the  events  of  the  past  few  years  have  demonstrated. 

"The  factors  concerned  in  the  diminution  of  malaria  in  the  Unit- 
ed States  are  interdependent;  their  importance  has  varied  with  time 
and  locality,  but  all  have  been  closely  related  to  the  agricultural  de- 
velopment of  the  country. 

"The  study  of  the  history  of  malaria  in  a  country  may  afford 
useful  information  as  to  the  best  means  of  combating  the  disease.     It 


A 


52 FLORIDA  STATE  BOARD  OF  HEALTH 

ADMINISTRATION 

is  very  desirable  that  such  study  be  continued  in  this  country,  since, 
as  the  years  pass,  necessary  data  become  more  and  more  difficult  to 
obtain." 

To  combat  malaria  in  Florida  more  local  health  activity  is  re- 
quired. All  counties  in  the  State  with  a  population,  of  20,000  or  more 
should  have  a  full-time  county  health  unit  operating  under  the  general 
supervision  of  the  State  Board  of  Health.  Smaller  counties  could 
combine  as  a  two  or  three  county  unit.  In  the  northern  portion  of 
the  state,  malaria  and  hookworm  aTe  the  most  important  points  of 
attack. 


BUREAU  CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 
Lucile  Spu-e  Blachly,  M.  D.t  Director 

PRELUDE— CHILD    HYGIENE 

As  happens  in  the  lives  of  individuals  there  recently  came  to  me 
four  opportunities  in  as  many  weeks  to  engage  in  educational  health 
work,  all  attractive,  all  interesting,  all  having  to  do  directly  with 
the  betterment  of  children — therefore,  the  race.  Race  betterment 
must  come  if  our  civilization  is  to  survive. 

After  careful  investigation  and  due  consideration,  1  elected  to 
come  to  Florida  and  my  chief  reason  for  so  doing  was  that  I  hoped  to 
have  the  opportunity  to  continue  the  constructive  child  hygiene  pro- 
gram 1  had  found  beginning  to  work  so  successfully  in  my  own  state. 
My  chief  reason  for  this  hope  was  that  Florida  heads  up  its  State  Board 
of  Health  with  a  man  of  character  who  not  only  has  had  sound  aca- 
demic and  medical  training  but  'who  also  has  had  a  long  and  success- 
ful career  as  a  public  health  executive. 

After  a  hurried,  but  nevertheless  thorough,  survey  of  Florida's 
social  assets,  I  am  even  more  encouraged.  As  I  see  it,  whatever  the 
future  purpose  of  the  Bureau  of  Child  Hygiene  may  be,  it  must  for  the 
present  play  a  dual  educational  role.  It  must  educate  to  keep  the 
well  child  well  and  educate  to  get  the  sick  or  defective  cured  if  possi- 
ble. To  be  effective  it  must  begin  its  ministrations  to  the  former  with 
its  conception.  No  single  Bureau,  no  matter  how  adequately  staffed 
or  generously  financed,  nor  no  health  department,  can  get  very  far 
without  the  whole-hearted  interest  and  cooperation  of  the  state-wide 
official  and  non-official  agencies  interested  in  the  health  and  welfare 
of  children. 

It  takes  safe  milk  and  safe  water  and  safe  sewage  and  green  leafy 
vegetables  and  fresh  fruit  and  fresh  eggs  and  fresh  meat  and  unspoiled 
grain  and  real  butter  and  fresh  air  and  the  right  temperature  and  sleep 
and  biologies  and  chemicals  and  autacoids  and  physicians  and  obste- 
tricians and  pediatrists  and  nurses  and  nutritionists  and  educators  and 
health  educationists  and  sanitarians  and  dentists  and  social  service  work- 


FLORIDA  STATE  BOARD  OF  HEALTH 21 

BUREAU  CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

ers  and  teachers  and  preachers  and  farmers  and  dairymen  and  fruit 
growers  and  economists  and  sociologists  and  statesmen  and  journalists 
and  psychologists  and  psychiatrists  and  dental  hygienists  and  county 
commissioners  and  city  councils  and  school  boards  and  public  opinion 
and  parents  that  care,  all  working  and  reacting  together  with  complete 
harmony  in  the  interest  of  the  child,  if  we  are  ever  to  approach  the  ideal 
set  us  by  President  Hoover  in: 

THE  CHILD'S  BILL  OF  RIGHTS 

(that) 
t 

"The  ideal  to  which  we  should  strive  is  that  there  shall  be  no  child 
in  America : 

That   has   not  been   born   under   proper   conditions. 

That  does  not  live  in  hygienic  surroundings. 

That  ever  suffers  from  undernourishment. 

That  does  not  have  prompt  and  efficient  medical  attention  and 
inspection. 

That  does  not  receive  primary  instruction  in  the  elements  of  hy- 
giene and  good  health. 

That  has  not  the  complete  birthright  of  a  sound  mind  in  a  sound 
body. 

That  has  not  the  encouragement  to  express  in  the  fullest  measure 
the  spirit  within  which  is  the  final  endowment  of  every  human  being." 

The  little  children  are  helpless.  We  are  responsible  for  and  to 
them.      Shall   they  cry  to  us  in  vain? 

THE  HEALTH  COUNCIL 

My  experience  as  a  business  woman,  teacher,  practicing  physi- 
cian and  public  health  worker  led  me  early  in  the  last  instance 
to  see  the  need  of  bringing  together  the  heads  or  representatives  of 
the  various  state-wide  official  and  non-official  agencies  interested  in 
the  child  if  we  were  to  accomplish  the  most  good  in  the  least  time  with 
the  least  cost.  Every  other  public  health  worker  seriously  interested  in 
his  problem  and  acquainted  with  the  vast  resources  inherent  in  these 
various  agencies  sooner  or  later  comes  to  the  same  conclusion  but  it 
was  left  to  the  American  Child  Health  Association  with  its  engineer- 
ing head  to  develop  the  technique  for  making  these  councils  function. 

Before  coming  to  Florida,  the  possibility  of  organizing  such  a 
Health  Council  here  was  gone  into  and  soon  after  my  arrival,  Mrs. 
Walter  McNabb  Miller,  Associate  Director  of  the  Division  of  Publica- 
tions and  Promotion  of  the  aforementioned  organization,  arrived, 
coming  on  invitation  of  Dr.  Henry  Hanson.     Mrs.  Miller  came  not  only 


54 FLORIDA    STATE    BOARD    OF   HEALTH 

BUREAU  CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

as  a  representative  of  the  American  Child  Health  Association,  but  as 
the  representative  of  the  White  House  Conference  by  reason  of  her 
association  with  Mrs.  Aida  de  Acosta  Breckinridge,  who  is  the  Director 
of  Public  Relations,  appointed  to  this  position  by  Secretary  Wilbur. 

Fortunately,  we  found  such  a  Health  Council  already  organized 
but,  unfortunately,  inactive.  Due  to  the  splendid  spirit  of  cooperation 
and  confidence,  one  in  the  other,  of  the  Governor,  the  State  Health 
Officer,  the  Superintendent  of  Public  Instruction,  and  the  officers  of 
the  Health  Council,  it  was  easy  for  the  former  to  get  together  a  repre- 
sentative group  of  men  and  women  in  the  Senate  Chamber  on  Feb- 
ruary 25  to  put  new  life  and  meaning  in  the  Health  Council  and  from 

that  meeting  to  develop  plans  for  the  celebration  of  May  Day Child 

Health  Day.  at  Gainesville.  May  first.  This  program  will  be  broad- 
casted over  WRUF  from  two  to  four  p.  m. 

During  the  year,  following  the  election  of  officers  on  May  first, 
County  Councils  will  be  organized  throughout  the  state.  These  County 
Councils  will  function  in  a  number  of  ways,  i.  e„  among  others,  they 
will  receive  and  disseminate  the  information  now  being  gathered  by 
the  White  House  Conference  Committee  and  plan  for  and  promote 
the  year-around  health  programs  to  culminate  in  an  appropriate  cele- 
bration and  stock  taking  on  May  Day  of  each  year. 

BUREAU  OF  DIAGNOSTIC  LABORATORIES 

Paul  Eaton,  M.  D.t  D.  P.  H.,  Director 

LABORATORY  NOTES 

In  order  that  the  members  of  the  medical  profession  in  the  State 
of  Florida,  who  depend  upon  the  State  Laboratory  service  for  aid  in 
the  diagnosis  of  various  conditions,  may  understand  the  difficulties 
under  which  the  laboratory  operates,  it  will  be  necessary  for  them  to 
know  something  about  the  amount  of  work  done. 

At  this  time,  we  will  only  present  figures  for  the  Central  Labor- 
atory at  Jacksonville,  but  we  hope,  in  the  near  future,  to  present  com- 
parable figures  for  the  branch  laboratories.  The  subjoined  table  gives 
the  total  number  of  tests  done  in  the  Central  Laboratory  for  each 
year  from  its  opening  in  1903  to  the  close  of  1929.  The  last  few 
numbers  are  given  to  the  nearest  thousand  only. 

When  the  Laboratory  was  young,  a  greater  variety  of  work  was 
done,  as  well  as  some  work  of  an  entirely  different  nature  from  that 
which  is  now  carried  on.  I  refer  to  tissue  work  or  the  histological  diag- 
nosis of  diseased  tissues.  That  kind  of  work  is  tedious  and  time  con- 
suming. It  has  not  been  done  in  the  Laboratory  for  twelve  or  thir- 
teen years.  From  these  remarks,  it  will  be  seen  that  the  number  of 
tests  during  the  past  twelve  years  can  not  be  compared  directly  with 
the  numbers  for  the  years  previous  to  that  time.     -But  since   1917,  at 


FLORIDA   STATE   BOARD    OF   HEALTH 55 

BUREAU  OF  DIAGNOSTIC  LABORATORIES 

least,  the  figures  are  directly  comparable.  It  is  true  that  technique 
has  been  improved  and  various  tests  have  been  simplified  so  that  the 
actual  amount  of  labor  involved  in  doing,  say,  1  000  tests  is  much  less 
than  would  have  been  required  1  2  years  ago.  Nevertheless,  the  figures 
speak  for  themselves. 

The  matter  of  greatest  importance  in  the  Central  Laboratory  is 
that  the  number  of  technical  workers  is  exactly  the  same  as  it  was 
1 2  years  ago.  Clerical  help  has  been  multiplied  by  three.  The  clerks 
are  busy  all  the  time  making  records  and  getting  out  reports  and  from 
this  fact  it  may  be   seen   that  the  technical  force  is  always  very  busy. 

A  little  relief  has  come.  In  the  latter  part  of  February,  an  addi- 
tional technician  was  employed,  and  it  is  hoped  that  within  a  few  weeks 
another  one  may  be  added.  This,  however,  will  only  furnish  six  wor- 
kers for  the  amount  of  work  that  needs  ten  or  twelve. 

From  the  time  laboratory  work  was  first  undertaken  by  the  Flor- 
ida State  Board  of  Health,  the  budget  has  allowed  the  Laboratories 
an  amount  in  excess  of  10%  of  the  total  expenditures.  This  amount 
is  evidently  insufficient  lo  provide  the  number  of  workers  necessary. 
How  it  is  to  be  increased  is  a  matter  to  be  determined.  The  activities 
of  the  other  Bureaus  cannot  be  curtailed  for  they,  too,  have  their  im- 
portance. The  only  way  so  far  as  we  can  see  now,  is  to  ask  for  a  larg- 
er appropriation  for  the  State  Board  of  Health. 

TOTAL  NUMBER  OF  TESTS  DONE  IN  THE  CENTRAL  LABORA- 
TORY FROM  ITS  OPENING  IN  1903  TO  THE  CLOSE  OF  1  929 


Number 

Specimens 

Year 

Examined 

1903 

996 

1904 

2.088 

1905 

2.896 

1906 

2,802 

1907 

3,202 

1908 

4,006 

1909 

5,762 

1910 

12.096 

1911 

10,576 

1912 

1  1,006 

1913 

14.516 

1914 

14,593 

1915 

19.708 

1916 

•19,749 

Number 

Specimens 

Year 

Examined 

1917 

18,231 

1918 

17.423 

1919 

28.585 

1920 

31,703 

1921 

36, 1  38 

1922 

35,682 

1923 

41,000 

1924 

48,000 

1925 

36,000 

1926 

61,999 

1927 

77.000 

1928 

77,000 

1929 

88,000 

56 


FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU    OF    DIAGNOSTIC    LABORATORIES 


SUMMARY  OF  WORK  DONE  IN  THE  LABORATORIES  OF 

THE  STATE  BOARD  OF  HEALTH 

DURING  THE  MONTH  OF  FEBRUARY,    1930 

Jacksonville     Tampa      Pensacola      Miami      Tallahassee      Total 

Animal  Parasites 3197 

Diphtheria    778 

Typhoid   „_ 3 1  5 

Malaria  953 

Rabies    -~ 1  5 

Tuberculosis   204 

Gonorrhea    „ 365 

Kahn     __. 3101 

Water:  Count  ...... 

Water:  Colon  „„ 

Milk:   Bacterial  Exam 65 

Milk:  Chemical  Exam 94 

Miscellaneous    1  63 


605 

60 

163 

147 

4172 

162 

14 

267 

9 

1230 

116 

13 

60 

29 

533 

145 

13 

15 

99 

1225 

3 

16 

89 

14 

78 

16 

401 

131 

29 

132 

38 

695 

439 

600 

5140 

36 

77 
96 

113 
96 

170 

6 

311 

22 

574 

181 

7 

70 

22 

374 

62 

29 

546 

223 

1023 

9250  3139   185  2415   605  15594 


Specimen  Containers  Distributed 


I  I  00 1 


BIOLOGICAL  PRODUCTS  DISTRIBUTED 

Diphtheria  Antitoxin.. _ 10,000   units  134  Packages 

5,000   units  59  Packages 

Toxin  Antitoxin 5,926  C.    C. 

Schick 3,860  Tests 

Tetanus  Antitoxin 20,000   units  37  Packages 

10,000   units  46  Packages 

J           1,500  units  857  Packages 

Anaerobic  Antitoxin „ L 1  00    c.    c.  9  Packages 

1 0   c.   c.  10  Packages 

Typhoid  Vaccine ..„ „.  1,258  Treatments 

Vaccine  Virus _ ^  2,690  Capillaries 

Antirabic  Virus.™. „_ I  9  Treatments 

Antimeningococcus  Serum 25  Cylinders 

Carbon  Tetrachloride 4,357  Capsules 

ALL  REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 

THE  STATE  LABORATORY,  STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 


FLORIDA  STATE  BOARD  OF  HEALTH 57 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

COUNTY  HEALTH  SERVICE 

The  County  Health  Unit  plan  is  growing  in  favor.  The  follow- 
ing is  quoted  from  an  editorial  in  the  Memphis  Times  Scimitar; 

"Counties  that  maintain  full-time  health  units  have  made  such 
progress  in  the  prevention  of  disease  as  to  convince  the  most  obstinate 
that  this  work  pays  dividends  in  life,  health  and  happiness,  to  say 
nothing  of  the  commercial  value  of  health  to  a  community." 

The  best  plan  for  the  County  Health  Officer  is  to  attack  first  one 
or  a  few  of  the  major  health  problems  of  his  community.  Whether 
it  is  maternal  and  infant  mortality,  tuberculosis,  malaria  and  hook- 
worm, water  and  sewerage,  or  other  factors  that  produce  sickness,  raise 
the  death  rate  and  tend  to  impoverish  the  people,  the  activities  of  a 
well  directed  health  unit  'will  quickly  bring  results.  Mortality  and 
morbidity  reports  year  after  year  show  marked  improvement  following 
the  establishment  of  a  county  health  service.  Specific  death  rates  from 
the  preventable  diseases  have  been  reduced  by  as  much  as  87%  for 
a  four  year  period. 

Malaria  is  said  to  have  caused  the  downfall  of  nations.  Hook- 
worm disease  has  retarded  the  development  of  the  entire  south.  Dur- 
ing the  Spanish -American  War,  more  American  soldiers  were  killed 
by  typhoid  than  by  bullets.  Florida  is  a  great  state.  On  HEALTH 
more  than  anything  else  the  continued  growth  and  prosperity  of  every 
section  and  county  depends.  Many  of  us  who  know  how  to  prevent 
disease  are  prone  to  neglect  the  simplest  protective  measures  such  as 
screening  and  sanitation. 

ENABLING  ACT 

The  writer  firmly  believes  that  there  should  be  legislative  au- 
thority for  the  appropriation  and  expenditure  of  county  tax  money 
for  county  health  service. 

A  HEALTH  CIRCUS 

Watch  your  local  paper  for  announcements  regarding  the  Health 
Demonstration  of  the  State  Board  of  Health.  By  learning  how  econo- 
mically to  mosquito-proof  your  home,  be  it  mansion  or  shack,  you  can 
save  on  the  cost  of  screening  and  on  the  cost  of  being  sick.  By  learn- 
ing how  to  prevent  soil  contamination  and  doing  it  you  can  protect 
your  children  from  hookworm  and  other  diseases.  Child  Hygiene 
and  Communicable  Disease  control  will  have  a  place  on  the  circus  pro- 
gram. 


58 FLORIDA   STATE    BOARD    OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

Listen  for  further  announcement  by  radio.  Ask  your  neighbors 
if  they  are  going.  Plan  on  taking  a  day  off  for  this  big  show  and  don't 
fail  to  bring  the  wife. 


LIFE  SAVERS 

The  typhoid  death  rate  per  hundred  thousand  people  in  Florida 
has  declined,  according  to  provisional  figures  released  by  the  Bureau 
of  Vital  Statistics,  from  24.2  in  191  7  and  27.3  in  191  8  to  8.0  in  1928 
and  5.3  in    1929. 

In  1929  there  were  83  deaths  reported  from  this  disease  and  that 
was  lower  by  38  than  the  figures  for  the  previous  year.  There  is  a 
reason  for  this  declining  death  rate,  or  rather,  there  are  several  reasons. 
Day  by  day  and  week  by  week  the  health  workers  are  campaigning 
against  disease.  Doctors,  nurses,  sanitary  officers  of  the  State,  county 
and  city  have  the  same  objective  and  that  is  to  improve  the  personal 
habits,  the  community  sanitation  and  the  general  immunity  of  the  peo- 
ple that  they  will  not  die  or  be  ill  from  preventable  sickness. 

"It  ain't  the  guns  nor  armament. 

Nor  the  funds  that  they  can  pay. 
But   the  close   cooperation 

That  makes  them  win  the  day. 

It  ain't  the  individual. 

Nor  the  Army  as  a  whole. 
But  the  everlasting  teamwork 

Of  every  bloomin*  soul,'' 


HOOKWORM  BLUES 

A  Gadsden  County  boy  had  been  examined  and  told  that  he  had 
hookworms.  Returning  home  from  the  State  Board  of  Health  motion 
picture  show,  where  he  had  seen  the  actual  workings  of  hookworms 
fastened  to  the  intestinal  lining,  he  complained  bitterly  of  abdominal 
pains  and  after  much  questioning  he  told  his  mother  that  "Those  hook- 
worms are  hurting  me.1' 

Unfortunately,  the  hookworms  do  not  cause  abdominal  pain.  If 
they  did,  the  victim's  complaints  would  finally  get  attention  and  bring 
relief.  The  hookworm  is  stealthy.  Its  ravages  are  insidious.  The 
juvenile  victims  do  not  complain  but  just  pine  away  and  too  often  the 
parents  let  them  pine. 


•        FLORIDA  STATE  BOARD  OF  HEALTH 59 

BUREAU   OF   COMMUNICABLE    DISEASES 

LOOKING  BACKWARD  OVER  FIFTY  YEARS  OF  HEALTH 
WORK    IN   FLORIDA.     (A  review— Continued  from  last  month) 

In  Key  West  at  the  close  of  the  Spanish-American  War,  when  a 
large  number  of  marines  were  quartered  ashore  and  a  fleet  swung  at 
anchor  in  the  harbor,  consternation  was  caused  by  the  appearance  of 
a  disease  at  first  declared  to  be  yellow  fever.  This  diagnosis,  made 
by  a  young  assistant  surgeon  of  the  Navy,  was  not  accepted  by  the 
representative  of  the  State  Board  of  Health  who  declared  the  disease 
to  be  dengue,   and  subsequent  developments  proved  him  correct. 

Another  incident  of  interest  "was  an  outbreak  of  smallpox  in  Key 
West  in  1896.  The  disease  had  gained  considerable  headway  when 
discovered  by  the  State  Board  of  Health,  and  since  the  law  compelled 
the  board  to  care  for,  maintain  and  guard  each  patient,  a  pest  house 
was  prepared  and  all  patients  ordered  removed  thereto.  The  Mayor 
refused  to  carry  out  this  order  so  the  city  was  quarantined  from  the 
rest  of  the  State.  The  Battleship  Maine  then  in  the  harbor  was  as- 
signed to  help  maintain  quarantine.  No  vessel  was  permitted  to  leave 
without  written  permit  stating  that  crew  and  passengers  were  satisfac- 
torily vaccinated.  One  fateful  afternoon  there  came  a  rumor  that  a 
steamer  was  aground  off  the  main  channel  from  the  Gulf.  A  launch 
from  the  Maine,  with  a  one-pound  gun  in  the  bow,  was  busy  rounding 
up  small  craft  that  sought  to  go  out  to  the  steamer.  A  certain  tug 
owner  had  boasted  that  his  vessel  would  not  be  stopped  if  occasion 
arose  to  leave  the  harbor.  His  was  among  the  other  boats  and  being 
faster  than  the  launch  soon  outdistanced  the  latter  nor  would  he  heed 
the  blank  shots  fired  from  the  launch.  A  blank  was  fired  from  the 
Maine  without  effect  but  when  a  shot  was  dropped  just  ahead  of  the 
tug  it  came  "hard  about,"  returned  to  port,  the  crew  was  vaccinated 
and  a  permit  issued.  That  shot  from  the  Maine  had  a  most  potent 
effect  in  enforcement  of  quarantine  regulations  in  after  years.  Another 
smallpox  outbreak  appeared  in  the  upper  border  counties  during  the 
1901  session  of  the  legislature.  Food  and  medical  care  were  still 
furnished  so  there  was  consolation  if  not  a  real  advantage  in  having 
smallpox.  Failing  to  get  a  compulsory  vaccination  law  through  the 
legislature  the  State  Health  Officer  offered  free  vaccination  to  all, 
discharged  the  guards,  furnished  groceries  only  to  the  very  poor  and 
placarded  all  the  houses  where  there  were  smallpox  patients.  Very 
soon  was  accomplished  what  the  proposed  law  sought  to  do.  People 
accepted  protection,  were  vaccinated  and  the  epidemic  was  terminated. 

The   Health   Train 

By  authority  of  the  1915  legislature  and  with  the  cheerful  co- 
operation of  the  railroads  and  the  Pullman  Company,  a  health  train 
or  moving  school  of  hygiene  and  sanitation  was  fitted  up  and  exhibited 
in  rural  communities  wherever  the  rail  lines  ran.  These  were  equipped 
with  models  and  text  cards  to  impart  information;  lectures  and  demon- 
strations were  given  on  the  different  phases  of  sanitation. 

Another  enterprise  for  which  credit  seems  divided  between  the 
Florida  State  Board  of  Health  and  Mr.  Richard  Dean,    then    general 


60 FLORIDA    STATE    BOARD    OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

manager  of  the  Pullman  Company,  was  the  installation  in  sleeping  cars 
of  the  first  dental  lavatories. 

Laboratory  Established 
Not   until    1901    was   the   State   Board   of   Health    Laboratory   at 
Jacksonville  opened  with  Dr.  Edwardo  Andrade  as  the  bacteriologist. 
Branch    laboratories   were   later   established    in    the   order   named   at 
Tampa,    Pensacola,  Tallahassee  and  Miami. 

Hookworm  disease  was  the  next  health  problem  to  receive  at- 
tention. Dr.  Porter  and  his  assistant,  Dr.  Hiram  Byrd.  made  a  trip  of 
inspection  to  the  western  seacoast.  They  observed  the  effects  of  the 
newly  discovered  parasite  on  the  children  and  many  of  the  adults  and 
were  convinced  that  efforts  should  now  be  directed  toward  its  eradica- 
tion. Accordingly.  Dr.  C.  T.  Young  and  Dr.  E.  W,  Diggett  were  sent 
out  with  thymol,  portable  microscopes  and  instructions  to  obtain  re- 
sults. The  benefits  of  their  effort  were  soon  apparent  but,  as  in  more 
recent  years,  sanitation  was  neglected  and  re-infection  resulted  so  that 
the  benefits  were  not  permanent. 

Between  the  State  Board  of  Health  and  the  County  Boards  which 
were  functioning  prior  to  the  establishment  of  the  State  Board  of  Health 
there  seems  to  have  been  some  overlapping  or  duplication  of  authority. 
This  had  to  do  mainly  with  maritime  quarantine  and  restriction  of  trav- 
el during  epidemics.  On  that  account  the  legislature  of  1697  abol- 
ished the  County  Boards  of  Health, 

The  last  appearance  of  yellow  fever  in  Florida  was  at  Pensacola 
in  1905  where  it  was  introduced  by  excursionists  returning  to  that  city 
after  a  trip  to  New  Orleans.  In  the  latter  city  the  fact  of  its  presence 
had  been  concealed.  The  Pensacola  epidemic  might  quickly  have  been 
controlled  but  for  a  sudden  exodus  of  panic  stricken  people  from  the 
section  in  which  it  first  appeared.  By  this  means  a  number  of  new  foci 
were  established  and  the  epidemic  lasted  nearly  three  months.  How- 
ever, its  spread  was  limited  to  a  radius  of  ten  miles  beyond  the  city 
limits  and  for  the  first  time  in  the  United  States  yellow  fever  was  con- 
quered before  the  advent  of  the  first  frost.  In  this  instance  the  cam- 
paign was  based  on  the  evidence  of  mosquito  transmission  gathered  in 
Cuba  by  Walter  Reed  and  his  associates  and  was  directed  mainly 
against  the  mosquito  carrier  of  the  infection.  Since  that  time  the  main 
objective  of  anti-mosquito  work  in  Florida  has  been  to  destroy  breed- 
ing places  and  screen  against  anopheles  mosquitoes  and  the  "pestifer- 
ous" varieties  in  order  to  control  malaria  and  promote  comfort.  In 
this  work  Dr.  Porter  was  actively  interested  almost  up  to  the  time  of 
his  death. 

Of  necessity,  many  interesting  episodes  and  details  contained  in 
the  original  article  have  been  omitted.  Many  readers  of  Health  Notes 
will  remember  still  other  incidents  and  facts  of  real  significance  in  their 
relation  to  the  history  of  public  health  in  Florida.  Dr.  Porter  has  given 
recognition  to  a  number  of  men  of  national  repute  and  to  prominent 
citizens  of  the  State  who  through  their  active  interest  in  hygiene  and 
sanitation,  have  contributed  bountifully  to  the  'welfare  and  develop- 
ment of  Florida.  To  all  who  are  interested  in  a  fascinating,  romantic 
and  soul  stirring  record  of  Florida  health  history,  the  reading  of  the  ori- 
ginal article  is  recommended. 


FLORIDA    STATE    BOARD    OF    HEALTH M 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

MARRIAGES    AND    DIVORCES 

During  the  calendar  year  1 929,  a  total  of 
18,198  marriages  was  performed  in  the  state  of 
Florida;  10,474  white.  5,811  colored  and  1,913 
with  color  or  race  unknown,  A  total  of  3,773 
divorces  and  20  annulments  were  granted.  There 
is  now  on  file  in  a  central  office  a  complete  index 
of  marriages,  divorces  and  annulments  beginning  with  the  mid -year 
of  1927,  Many  attorneys,  social  workers,  police  courts  and  others 
requiring  definite  information  concerning  individuals  in  question  have 
found  the  central  record  a  short  cut  that  has  proven  very  valuable. 
In  the  August,  1929  issue  of  HeaUh  Notes,  under  the  caption 
"Marriages  To  Date",  very  brief  tabulations  were  put  on  record  dat- 
ing from  1867  to  the  time  the  law  centralizing  the  records  went  into 
effect.  The  table  on  pages  63  and  64  of  this  issue  indicates  the  mar- 
riages performed  and  divorces  and  annulments  granted,  by  counties, 
for  last  year. 


STATEMENT    OF   THE    OWNERSHIP,   MANAGEMENT.    CIRCULATION,    ETC.,    REQUIRED 
BY    THE    ACT    OF    CONGRESS    OF    AUGUST    24.    1912. 
OF   FLORIDA  HEALTH    NOTES   published    monthly  at   Jacksonville,    Florida   for  April 
I,    1930, 
State  of   Florida 

SB. 

County  of   Duval 

Before  me,  a  Notary  Public,  in  and  for  the  State  and  county  aforesaid,  personally 
appeared  Stewart  G.  Thompson.  D-  P.  H.,  who.  having  been  duly  sworn  according  to  low, 
deposes  and  says  that  he  is  the  editor  of  the  Florida  Health  Notes  and  that  the  following 
is,  to  the  best  of  his  knowledge  and  belief*  a  true  statement  of  the  ownership,  management 
{and  if  a  daily  paper,  the  circulation) ,  etc,  of  the  aforesaid  publication  far  the  date 
shown  in  the  above  caption,  required  by  the  Act  of  August  24,  1912.  embodied  in  section 
443,    Postal   Laws   and    Regulations,    printed   on    the   reverse    side    of    this    form,    Lo-wjL: 

~\  I*      That     the    names    and     addresses    of     the    publisher,    editor,     managing    editor,    and 
business   managers  are: 

Publisher,    Florida    State    Board    of    Health,    Box    4479.    Jacksonville,    Fla. 
Editor,    Slewart    G.    Thompson,    D.    P.    H.,    Box   4479,   Jacksonville.    Fla. 

2.  That  the  owner  is:  (If  the  publication  is  owned  by  an  individual  his  name  and 
address,  or  if  owned  by  more  than  one  individual  the  name  and  address  of  each,  should 
be  given  below;  if  the  publication  ta  owned  by  a  corporation  the  name  of  the  corpora- 
tion and  the  names  and  addresses  of  the  stockholders  owning  or  holding  one  per  cent 
or  more  of  the   total  amount  of  stock  should   be  given.) 

Florida    State   Board   of   Health,    Box    4479,    Jacksonville,    Fla. 

3.  That  the  known  bondholders,  mortgagees*  and  other  security  holders,  owning  or 
holding  1  per  cent  or  more  of  total  amount  of  bonds,  mortgages,  or  other  securities  are: 
(If    Mxrrr    are    non*,    no    stattO        None. 

4.  That  the  two  paragraphs  next  above,  giving  the  names  of  the  owners,  stockholders, 
and  security  holders,  if  any.  contain  not  only  the  Ust  of  stockholders  and  security  holders 
as  they  appear  upon  the  books  of  the  company  but  also,  in  cases  where  the  stockholder 
or  security  bolder  appears  upon  the  books  of  the  company  as  trustee  or  in  any  other 
fiduciary  relation,  the  name  of  the  person  or  corporation  for  whom  such  trustee  is  acting 
is  given;  also  that  the  said  two  paragraphs  contain  statements  embracing  affiant's  full 
knowledge  and  belief  as  to  the  circumstances  and  conditions  under  which  stockholders 
and  security  holders  who  do  not  appear  upon  the  books  of  the  company  as  trustees,  hold 
stock  and  securities  in  a  capacity  other  than  that  of  a  booa  fide  owner;  and  this  affiant 
has  no  reason  to  believe  that  any  other  person,  association  or  corporation  has  any  interest 
direct  or  indirect   in  the  said  stock,   bonds,  or  other  securities   than  as  so  stated  by  him. 

5.  That  the  average  number  of  copies  of  each  issue  of  this  publication  sold  or  dis- 
tributed through  the  mails  or  otherwise,  to  paid  subscribers  during  the  six  months  pre- 
ceding the  date  shown  above  is:  (This  information  is  required  from  daily  publications 
only.) 

Stewart  C.  Thompson- 
Sworn    to    and    subscribed    before    me    this    25th    day    of    March,     I9J0. 

A    Screven    Dozfer, 

Notary    Public   for   the   State  of   Florida   at   Large. 
My   Commission  expires   October   4,    193  J. 
(Seal) 


62 


FLORIDA  STATE  BOARD  OF  HEALTH 


LITTLE  TALKS  ABOUT  BIG  DISEASES 

WILLIE  AND  THE  "SCHICK  TEST" 


GOOD  Morning, 
Mrs.  Green, 
I'm  so  glad  to 
see  you.  I'm  all  upset. 
Sit  down  here  where 
it's  warm.  I  want  to 
ask  you  something  — 
wait  till  I  find  it. 
Where  did  I  put  that 
letter  Willie  brought 
home  from  school  yes- 
terday? Oh  yes,  here  it 
is— now  what  do  you 
make  out  of  such  as  this? 

Dear  Madam — that's  me  I  sup- 
pose— The  Sheet  test  is  being 
given  to  childn  n  in  No.  6  School 
next  week.  Tell  me  now  will 
you,  Mrs.  Green,  what's  that  got 
to  do  with  Willie?  He  says  they 
just  stick  a  needle  in  you  and  it 
don't  hurt  a  tall.  They  might  have 
to  stick  pins  and  needles  in  him 
to  find  out,  if  he's  alive,  but  he 
ain't  no  Sheek  I  can  tell  'em  with- 
out no  test.  I  won't  stand  for  none 
of  this  monkey  business. 

Yes,  there  is  some  more  to  the 
letter — This  test,  as  you  know 
— as  I  know — how  should  I  know 
■ — is  to  determine  whether  or  not 
persons  are  naturally  immune  *  *  * 
In  cases  where  the  test  is  positive 
immunity  is  conferred  by  the  tox- 
in-antitoxin innoculation  —  and  a 
lot  more  of  such  junk — and  a  place 
for  me  to  sign  yes  or  no  about 
something.  Tell  me,  Mrs.  Green, 
has  Willie  been  doing  something 
that  he  shouldn't,  or'are  the  school 
people  goin'  cuckoo,  or  what? 


You  can't  imagine 
what  a  load  you've 
taken  off  ray  mind  Mrs. 
Green,  If  the"sc  letters 
explained^things  as 
plain  as  you  do,  we 
might  know  what 
they're  talking  about. 
Your  three  children 
had  it  at  School  Num- 
ber 5,  and  even  the 
baby  at  the  clinic,  and 
he    didn't    even     cry? 

Atn't  that  wonderful!  I  guess  I 
know  all  there  is  to  know  about 
diphtheria.  Didn't  my  poor  little 
Annie  die  of  it  ten  years  back? — 
"Croup"^-old  Doc  Whoosis  called 
it — the  poor  dear,  she  just  choked 
to  death  right  in  front  of  our  very 
eyes.  When  the  Board  of  Health 
found  out  about  it  they  were  awful 
mad — said  the  case  should  of  been 
reported.  Some  other  children 
must  of  caught  it  when  they  came 
to  see  Annie.  They  roasted  the  old 
Doc  good  and  proper — served  him 
right.      How  did   I   know? 

Well,  if  this  Schick  test  and 
toxin-antitoxin,  or  whatever  you 
call  it,  will  keep  Willie,  or  any- 
body else,  from  having  diphtheria, 
I'm  for  it.  I'll  sign  this  blank 
quick  and  tell  Willie  to  give  it  to 
his  teacher  the  first  thing  in  the 
morning.  Just  think.  Mrs.  Green, 
if  poor  little  Annie  could  of  had 
this  she'd  probably  be  with  us  now. 
I  certainly  learned  something  to- 
day. Thank  you  so  much,  Mrs. 
Green  Good  bye.  Do  come 
again. 


i  A.  p.  H.  A, 


FLORIDA  STATE  BOARD  OF  HEALTH 


63 


BUREAU  OF  VITAL  STATISTICS 


Marriages  Performed,   (by  Color),  Divorces  and  Annulments  Granted, 

by  Counties — 1929 


COUNTIES 

MARRIAGES 

DISSOLUTIONS 

Total 

White 

Colored 

Unknown 

Divorces 

Annul- 
ments 

0 

State 

18.(98 
403 
203 
133 
157 
150 

622 
98 
83 
83 

186 
25 

234 
1,250 

105 

120 
1,758 

673 

87 
56 
399 
61 
59 
57 

230 

170 
17 
86 

1  18 
1.647 

138 
83 

350 

207 
63 

250 

10,474 

192 

23 

65 

106 

82 

462 
65 
58 
48 

129 
18 

125 

929 

70 

1,079 
433 

59 
25 
85 
40 
24 
37 

5 

139 

2 

54 

70 

1.306 

127 
43 
13 
73 

127 

5,811 
211 

6 
67 
45 
68 

160 
32 
25 
35 
57 
7 

107 

321 

33 

668 
221 

28 
31 
147 
16 
35 
20 

4 
30 

31 

47 

340 

11 

40 

16 

133 

122 

1,913 

174 
1 
6 

....... 

0 
0 

2 

2 

120 

11 

19 

167 
5 

221 

1 

15 

1 

1 

321 

I 

63 

1 

3.773 
61 
A 
17 
11 
35 

41 
5 

11 
8 
6 
1 

28 

587 

14 

13 

685 

150 

2 
•5 
18 
5 
3 
5 

12 
29 
7 
13 
13 
487 

9 

8 

36 

8 

5 

57 

20 

1. 

2. 
3. 
4. 
5. 

ft 

Alachua 

Baker 

Bay 

Bradford 

Brevard , 

Broward 

7. 
55. 

8. 

9. 
67, 

Calhoun __ 

Charlotte 

Citrus.. ...   ..    .. 

Clay , 

Collier. 

1 

10 

Columbia 

11. 
12. 

56 

Dade 

DeSoto 

*Dixie 

2 

n. 

Duval.. 

7 

14. 

53. 

15, 

Escambia 

Flagler 

Franklin 

1 

16 

Gadsden  ., 

64. 
57. 

Gilchrist 

Glades 

...... 

65. 

17. 
58. 

Gulf 

Hamilton 
Hardee 

1 
1 

63. 
16. 
59. 
19. 

20. 

66. 
21. 
22. 

Hendry 

Hernando 

Highlands _ 

Hillsboro 

Hoi  mes „ 

Indian  River 

Jackson 

Jefferson 

1 

23. 
24. 

*  Lafayette 

Lake 

• — 

64 


FLORIDA    STATE    BOARD    OF   HEALTH 


BUREAU  OF  VITAL  STATISTICS 

Marriages  Performed,   (by  Color),  Divorces  and  Annulments  Granted, 
by  Counties — 1929 — (Continued) 


COUNTIES 

MARRIAGES 

DISSOLUTIONS 

Annul- 
ment* 

Total 

White 

Colored 

Unknown 

Divorces 

25. 

Lee 

118 

84 

.  34 

48 

26. 

Leon „ 

257 

94 

162 

1 

55 

27. 

Levy 

163 

88 

75 

6 

....„ 

28. 

Liberty 

37 

21 

11 

5 

1 

_____ 

29. 

Madison 

296 

162 

134 

18 

_____ 

30. 

Manatee 

2J8 

136 

82 



16 

— 

31. 

M  ari  o  n  „ ™  .„ 

337 

155 

182 

33 

67. 

Martin 

61 

46 

35 



4 

32. 

Monroe. 

146 

125 

21 

38 

3^ 

Nassau 

202 

211 

76 

128 
2 

74 

211 

74 

9 

13 

9 

34 

Okaloosa 

54. 

Okeechobee 

...... 

35. 

Orange 

513 

299 

213 

1 

168 

1 

36 

Osceola 

269 
526 

179 
301 

89 
224 

1 
1 

21 
147 

37. 

Palm   Beach 

1 

38. 

Pasco 

175 

137 

38 

30 

39. 

Pinellas.  ~     

609 

470 

139 

172 

40. 

Polk 

787 

542 

241 

4 

180 

2 

41, 

Putnam 

220 
323 

91 

222 

129 
100 

1 

29 
39 

42. 

St.  Johns * 

„... 

43. 

St.  Lucie 

99 

58 

36 

3 

26 

44. 

Santa  Rosa 

281 

3 

2 

276 

1  1 

60 

Sarasota 

146 
317 

99 
123 

46 
194 

T 

54 
41 

i 

45. 

Seminole 

46. 

Sumter..._ _ 

118 

68 

50 

25 

47. 

Suwannee 

21  1 

115 

90 

6 

21 

.- 

48. 

*Taylor _  

183 

183 

18 

_.,.. 

61. 

Union 

86 

53 

33 

9 



49. 

Volusia 

403 

237 

166 

101 

„„»_.. 

50 

Wakulla..... 

76 
196 

56 
144 

20 
43 

9 

2 
21 

51. 

Walton 

52. 

Washington 

157 

123 

32 

2 

7 

— 

*  Figures  from  County  Judge — original  licenses  not  received. 


This  Issue  Exceeds   1  1,000  Copies 


pLORlD^ 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY,    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  in  Second   Giu  Matter,  October  27,    1921 
at  the   Po.loffke  at  Jacksonville.   Florida,   Under   the  Act    of   Augutt   24.    1912 

Thia  Bulletin  will  be  lent  to  any  address  in  the  State  free  of  charge. 

Vol.  22  MAY.    1930  No.  5 


Edited    by 

STEWART  G.  THOMPSON,  D.P.H..  Member 
American   Medical  Editor*'   and    Author*'   Ann. 


SPECIAL  ARTICLES 

RABIES  —  Hanson 

VACATION    TIME  —  Brink 

MOSQUITO  -  PROOFING— Filby 

LABORATORY  TECHNIQUE— Eaton 

WHITE  HOUSE  CONFERENCE— Blackly 

DEATHS     BY     COUNTIES— 1929— Thompson 


HENRY  HANSON,   M.  D..  STATE  HEALTH  OFFICER 


66  FLORIDA   STATE   BOARD    OF   HEALTH 


BOARD   MEMBERS 

Chas.    H.    Km    Pit:  H.    Mason   Smith,    M.    D.       Wm.  D.  Nobles,   M.  D. 

Jacksonville  Tamps  Penaacola 

STATE  HEALTH  OFFICER 

Henry    Hanson,    M.    D. 

BUREAUS  AT  JACKSONVILLE  DIRECTORS 

Diagnostic  Laboratories— — Paul  Eaton,  M.  D.,  D.   P.   H. 

•Vital    Ststietics____ Stewart  G.  Thompson.   D.  P.   H. 

Communicable    Diseases — ,- F.  A.  Brink.  M.  D. 

Engineering — — . „ Ellsworth   L.   Fllby,  C  .E. 

Child  Hygiene  and  Public  Health  Nursing Lucile    Spire    Blachly,    M.    D. 

Accounting — . —_ _.   Screven  Doiier 

Crippled  Children F,   L.   Fort,  M.  D. 


\ 


•550   Local  RegJetrars    (Count?  lUt   faroiihed  on  nqont), 

•Registration    Inspector , Anna  C.  Emmooi 

Drug  Store   Inspector , ^,- , H*  R,  Monroe 

Drug    Store    Twp^tftt  , W.    A-    Mahoney 


LABORATORIES 

Jacksonville-. Pearl   Griffith,   B.   E. 

Miami „  E.  R.    Fowell 

Pensacola _ Janie  B.  Cur  He.  B.  S. 

Tallahassee Elizabeth  Byrd.   B.  S. 

Tampa „___    H.   D.  Venter*.  B.  3. 

MEDICAL  OFFICERS 


DeFuniak    Springs    ..„   .  ,. __ „ C.    W.    McDonald,    M.    D. 

Jacksonville B.  C,  Wilson.  M.  D. 

Melbourne __ —    W.   A.   Ctaiton,   M.    D. 

Quincy „ „ — .,  ,, A.  C,  Hamblin.    M.   D. 

Tallahassee A.   P.  Harrison,  M.  D. 

Tampa Chas.    W.    Peaae.    M.    D. 


DISTRICT   SANITARY   OFFICERS 

Tampa *V.  B.  Lamoureux.  C.   E. 

Jacksonville Fred   A.    Safay 

Miami George  B.   Reed 

Ocala C»   A.    Holloway 

Orlando .— , — — «. — ., „..,„.i,.,»,1-i„J — _- Russell    Broughman 

Punta  n***'**  G.  A.  Renoey 

Tallahassee C.  N.  Hobbs 

Tampa D.  H.  Oeburn 

'Assistant  Engineer 


PUBLIC   HEALTH  NURSES 

Lake  City 'Clio    McLaughlin,    R.    N. 

Tampa 'Harriet    t.   Sherman,  R.  N. 

Arcadia Jule   Craves,  R.  N. 

DeFuniak  Springa Nanna  Colby,   R.   N. 

Eden,   R.   F.   D.   Jensen . Sarah   Ida    Richards,   R,    N. 

Lake    City Frances  Hall,  R.  N 

Madison Thora   Roberta.   R.  N. 

Ruskin Joyce  Ely,  R.   N. 

Starke Mary  G.  Dodd,  R,  N, 

•Field   Supervisor 


FLORIDA  STATE  BOARD  OF  HEALTH <tf 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

MEETINGS 

WHY  so   many  meetings? 

During  the  past  month  there  have  been  meetings  and  conven- 
tions of  many  varieties,  in  addition  to  the  regular  established  weekly 
club  and  church  affairs.  The  promoters  of  each  of  these  endea- 
vored to  make  you  feel  that  the  future  welfare  of  the  race  depended 
on  the  impression  you  carried  away  from  these  gatherings. 

Among  the  gatherings  within  the  past  few  weeks  there  have 
been  the  annual  meeting  of  the  Florida  Federation  of  Woman's  Clubs, 
the  state  convention  of  the  Parent-Teachers'  Association.  The  Florida 
Anti-Mosquito  Association.  The  Southeastern  Water  Works"  Associa- 
tion in  conjunction  with  the  Short  Course  in  Water  Analysis  in  a  joint 
project  with  the  Engineering  Department  of  the  University  of  Florida 
and  the  State  Board  of  Health  Bureau  of  Sanitary  Engineering,  and 
in  Jacksonville,  the  Annual  Conference  of  Social  Workers  of  the  State, 
besides  the  meeting  of  the  Florida  Bar  Association  and  the  Library 
Association.  Most  of  these  carried  some  phases  of  a  health  program 
and  had  one  or  more  members  of  the  State  or  City  Health  Depart- 
ments actively  participating  in  the  deliberations. 

The  legal  fraternity  and  the  newspaper  men  did  not  invite  any 
representatives  of  the  Health  Department,  presumably  because  their 
deliberations  were  thought  to  have  no  bearing  on  policies  affecting 
health  and  happiness;  yet  these  two  outstanding  factors,  as  cogs  in 
the  wheel  of  government,  are  vital  in  an  effective  health  program. 
The  legal  fraternity  tells  us  the  manner  of  procedure  in  guiding  human 
beings  to  avoid  illness  in  the  quest  for  prosperity  and  contentment. 

The  library  is  our  store  house  of  knowledge.  We  go  to  it  for 
the  accumulated  experiences  of  the  ages.  The  men  of  the  press 
gather  and  disseminate  information  and  without  them  it  would  be  dif- 
ficult to  carry  on. 

In  what  we  regard  as  civilized  countries  it  has  been  found  that 
certain  restrictions  must  be  observed  if  social  contact  is  to  continue 
without  punitive  consequences;  e,  g.,  you  cannot  kiss  a  person  who  has 
diphtheria  without  taking  the  natural  consequences  if  you  have  not 
in  some  way  at  some  previous  time  been  immunized  against  this 
disease.  Hence,  it  is  necessary  to  have  health  laws,  regulations  based 
on  experience  in  the  evolution  of  the  human  race  which,  if  observed, 
will  prevent  the  occurrence  of  diphtheria,  typhoid,  smallpox  and  all 
the  ills  which  follow  when  infection  is  carried  from  person  to  person  by 
unwise  action. 

All  the  meetings  have  had  a  common  objective,  prosperity,  hap- 


68 FLORIDA   STATE   BOARD   OF   HEALTH 

ADMINISTRATION 

piness.--and  health.  No  one  can  be  prosperous  if  constantly  ill  and 
he  surely  Is  not  happy  if  always  ailing.  Health  is.  therefore,  the  key- 
note of  all  effort  and  indirectly  the  ultimate  objective  of  the  meetings. 

Probably  the  biggest  and  most  important  of  meetings  was 
that  of  the  State  Health  Council  held  in  Gainesville  May  1  st — 
National  May  Day,  Children's  Day.  A  nation  cannot  be  healthy  and 
happy  unless  the  children  are  healthy  and  happy. 

TUBERCULOSIS 

Occasionally,  reports  come  to  the  Health  Department  of  a  new 
cure  for  tuberculosis  or  of  some  physician  who  has  developed  a  new 
method  of  treatment  thereby  arousing  an  unjustified  optimism  on  the 
part  of  the  unfortunate  who  have  contracted  this  disease. 

The  person  who  knows  that  he  has  a  tuberculous  infection, 
•whether  it  be  of  the  lungs  (consumption)  or  of  the  bones,  glands  or 
what  not,  we  advise  not  to  become  despondent.  The  majority  of 
persons  who  have  reached  adult  age  have  at  some  time  had  an  in- 
fection of  tuberculosis  in  some  part  of  the  body.  Those  who  have 
had  proper  food,  adequate  rest  and  a  judicious  amount  of  exercise 
and  abundance  of  fresh  air  have  overcome  the  infection  and  will 
continue  well  so  long  as  they  refrain  from  over-taxing  the  physical 
reserve  which  has  been  built  up.  In  other  words,  lead  a  normal  life, 
eat  well,  sleep  'well  in  an  abundance  of  fresh  air  and  work  only  up 
to  the  point  of  being  normally  tired  but  not  to  exhaustion. 

Recently,  the  U.  S.  Government  Food  and  Drug  Department 
exposed  the  spurious  claims  of  a  patent  medicine  "B.  M.,'7  a  sub- 
stance claimed  to  have  curative  powers  by  being  rubbed  into  the  skin. 

Not  long  ago,  it  was  reported  that  there  were  some  injections 
which  would  bring  about  a  cure.  Health  Notes  does  not  know  of  any 
benefit  to  any  tuberculosis  patient  as  a  result  of  the  claims  made  by 
B.  M.  or  the  "new  injections''.  More  benefit  will  result  by  spending 
the  money  for  good  nutritious  food,  especially  a  good,  pure  quality  of 
milk. 

RABIES 

Letters  have  come  to  the  office  of  the  Board  of  Health  report- 
ing a  serious  rabies  situation  in  some  areas  within  the  State.  This 
should  have  the  careful  consideration  of  all,  especially  those  having 
the  duty  of  enforcing  regulations  affecting  dogs,  at  times  and  in  places 
where  mad  dogs  have  been  found.  No  dog  should  be  allowed  to  run 
at  large  unless  it  be  properly  muzzled.  All  dogs  that  have  not  been 
immunized  should  be  immunized  or  killed  without  any  further  delay. 

Health  Officers,  Sheriffs,  Chiefs  of  Police  and  Constables  will 
kindly  note  and  put  into  effective  operation  means  for  preservation 
of  life  and  human  safety. 


FLORIDA    STATE   BOARD   OF   HEALTH 69 

BUREAU   OF   DIAGNOSTIC    LABORATORIES 
Paul  Eaton,  M.   D.,   Director  of  Laboratories 

NOTE   ON   TECHNIQUE 

For  the  benefit  of  laboratory  workers  and  physicians  who  do 
their  own  microscopic  work,  we  give  a  recent  modification  of  the 
Wright  blood  stain  which  is  at  least  fifty  per  cent  better  than  the 
original. 

A  blood  smear  on  a  slide  is  flooded  with  the  regular  Wright 
stain  which  is  a  solution  of  certain  dyes  in  methyl  alcohol.  The  ex- 
cess of  solution  is  drained  off,  leaving  merely  what  will  cling  to  the 
slide  when  it  is  held  at  an  angle  of  45  degrees.  The  slide  is  then 
observed  in  a  good  light  until  it  is  seen  to  turn  red  when  a  few  drops 
of  distilled  water  are  put  on  it  and  left  for  about  a  minute,  when  it 
is  washed  and  dried. 

If  examined  under  the  microscope  at  this  point,  it  will  be  found 
to  be  overstained  and  probably  marred  with  the  precipitate,  which 
is  the  worst  feature  of  the  standard  Wright  stain. 

It  is  then  washed  with  a  solution  of  the  same  powder  used  in 
making  the  first  stain  in  85  %  ethyl  alcohol.  This  washes  off  the 
precipitate  and  decolorizes  the  overstained  smear.  The  slide  may  be 
decolorized,  washed  and  dried  any  number  of  times  found  necessary 
to  bring  out  the  best  detail. 

Abstracted  from  the  following  article: 

"A  Blood  Stain  Giving  More  Constant  Results."  Roy  F. 
Feemster,  M.  D.,  D.  P.  H.,  and  Olive  S.  Feemster,  A.  B.  From  the 
Department  of  Bacteriology  and  Pathology  of  Tulane  University  of 
Louisiana. 

Journal  of  Laboratory  and  Clinical  Medicine.  Vol.  1 3,  Page 
1139,  September,   1928. 


It  is  difficult,  if  not  impossible,  for  outsiders  to  appreciate  the 
amount  of  work  done  in  the  Laboratories  of  the  State  Board  of  Health. 
Doubtless,  many  of  you  have  from  time  to  time  glanced  over  the 
statistical  reports  from  the  Bureau  of  Laboratories  but  mere  figures  give 
a  poor  idea  of  the  actual  conditions. 

Let  us  take,  for  example,  the  amount  of  ■work  involved  in  the 
doing  of  the  38,937  Kahn  tests  reported  by  the  Central  Laboratory 
in  1 929.  Each  specimen  must  be  centrifuged  to  separate  the  serum 
from  the  clot.  The  serum  is  then  pipetted  into  a  second  tube  in 
which  it  is  inactivated,  that  is  to  say,  heated  to  56"  C  for  30  minutes. 
Measured  portions  of  each  sample  are  then  put  in  each  of  four  tubes 
which  contain  certain  reagents. 

The  tubes,  held  in  copper  racks,   are  then  shaken  vigorously  in 


70 


FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU    OF   DIAGNOSTIC    LABORATORIES 

a  machine  constructed  for  the  purpose,  for  three  minutes,  and  another 
reagent  is  added.  Each  tube  then  must  be  scrutinized  and  the  result 
of  the  test  recorded. 

From  this  resume,  it  will  be  seen  that  each  test  requires  the 
use  of  2  pipettes,  and  5  tubes,  not  counting  the  pipettes  used  in  the 
addition  of  the  reagents  above  referred  to.  This  means  that  this 
Kahn  work  alone  required  the  use  of  77,874  pipettes  and  194,685 
test  tubes. 

Now  these  tubes  and  pipettes  had  to  be  washed,  cleaned,  dried 
and  in  some  instances,  sterilized.  The  mere  washing  of  such  an 
amount  of  glassware  is  no  small  task. 

When  it  is  further  considered  that  the  Kahn  tests  referred  to 
constituted  about  one  third  of  the  work  done  in  the  Central  Labora- 
tory, it  will  be  seen  that  the  staff  of  four  technical  workers  did  not  have 
a  great  deal  of  spare  time. 

SUMMARY  OF  WORK— MARCH,    1  930 

Jacksonville      Tampa      Penaacola      Miami      Tallahassee      Total 


Animal  Parasites 
Diphtheria 

Typhoid   

Malaria  


Rabies „. 

Tuberculosis  

Gonorrhea    .._„ 

Kahn    

Water:  Count  .: 

Water:  Colon  _ 

Milk:  Bacterial  Exam. 
Milk:  Chemical  Exam. 
Miscellaneous   


3975 
460 
308 
674 
25 
174 
423 

3226 


59 
124 

123 


1475 

141 

84 

128 

88 

189 

1362 

32 

175 

188 

31 


27 
13 
25 
24 

6 
25 


10 
12 


1  10 

207 
68 
20 

56 
133 
629 
104 
127 
319 
464 
189 


62 
12 
36 
92 

22 
36 


23 

23 

114 


5649 
833 
521 
938 
25 
346 
806 

5217 
136 
127 
576 
809 
469 


9571      3893        142      2426        240    16452 
Specimen  Containers  Distributed   _ 13322 

BIOLOGICAL   PRODUCTS    DISTRIBUTED 


Diphtheria  Antitoxin 10,000   units 

5,000    units 

Toxin  Antitoxin _.... 

Sc  hick - ~— - 

Tetanus  Antitoxin 


Anaerobic  Antitoxin.. 

Typhoid  Vaccine 

Vaccine  Virus..... 
Antirabic  Virus.. 


20,000 

1 0,000 

1.500 

100 

10 


units 
units 
units 

c.   c. 

c  c 


Antimeningococcus   Serum.. 
Carbon  Tetrachloride 


100  Packages 

9  Packages 

9,702  C.   C. 

3,650  Tests 

1  0  Packages 
9  Packages 

862  Packages 

2  1  Packages 
26  Packages 

2,980  Treatments 

3,  1  60  Capillaries 

26  Treatments 

34  Cylinders 

3,315  Capsules 


FLORIDA   STATE   BOARD   OF   HEALTH 71 

CHILD   HYGIENE   AND   PUBLIC   HEALTH    NURSING 
Lucile  Spire  Blachly,  M.  D.,  Director 

THE  AMERICAN  CHILD  HEALTH  ASSOCIATION 
CONFERENCE  FOR  THE  STATE  MAY   DAY  CHAIRMEN 

Now  that  public  attention  is  focusing  upon  the  child  in  Florida 
as  elsewhere,  we  believe  the  readers  of  this  page  will  be  especially 
interested  in  the  recent  conference  for  the  State  May  Day  Chairmen 
at  Washington  April   1 0  to    12. 

Every  state,  including  Hawaii  and  Porto  Rico,  was  represented . 
Certain  cities,  including  New  York  City,  were  also  represented.  The 
roll  call  of  states,^  with  each  May  Day  Chairman  responding  with  a 
brief  report  of  the  more  important  phases  of  old  work  finished  and 
new  work  begun  or  to  begin  on  May  Day,  was  preceded  by  addresses 
by  Dr.  H.  E.  Barnard,  Director,  on  the  "Outlook  of  the  White  House 
Conference" ;  Dr.  Pierce.  Assistant  United  States  Public  Health  Of- 
ficer, speaking  in  the  absence  of  Dr.  Hugh  S.  Cumming,  Surgeon 
General,  on  "A  Rounded  Health  Program'',  and  Secretary  of  the 
Interior,   Dr.  Ray  Lyman  Wilbur,   on   "The  Opportunity  Before  Us." 

Dr.  Wilbur's  address  was  the  outstanding  feature  of  the  Con- 
ference, coming  as  it  did  the  day  after  the  signing  of  the  Jones-Parker 
Bill  which,  after  many  years  of  legislative  endeavor,  initiates  a  better 
coordination  of  health  activities  in  the  several  Federal  bureaus.  Dr. 
Wilbur  believes  stimulation  for  better  health  should  come  from   the 

central  government stimulation  of  two  sorts,  leadership  and  money 

but  of  the  two,  leadership  is  the  more  important.  "I  have  a  feeling," 
he  said,  "that  we  'will  never  develop  a  real  democracy  unless  we 
develop  it  with  a  local  significance  and  interest,"  and  again.  .  .  .  "If 
we  are  to  succeed  in  the  development  of  a  large,  widespread  local 
interest,  we  must  have  a  more  unified  program  for  education,  health, 
and  welfare  and  we  must  unite  here  in  Washington  on  such  a  pro- 
gram and  reflect  out  in  the  states  whatever  wa  may  be  doing  and 
what  we  can  do.  Those  of  you  who  are  primarily  interested  in  edu- 
cation realize  that  education  of  the  modern  type  cannot  be  disasso- 
ciated from  the  welfare  of  the  modern  child  and  those  of  you  who 
are  interested  in  public  health  know  that  it  cannot  be  disassociated 
from  education  and  welfare.      You  know  perfectly  well   that  without 

health  and  education,  you  get  nowhere  in  work  for  child  welfare 

If  we  can  all  unite  in  a  common  program  and  secure  legislation  that 
is  conservative  and  yet  in  the  right  direction,  I  think  we  can  build 
on  the  coordination  of  effort  and  knowledge  that  the  White  House 
Conference  will  bring  us,  together  with  the  general  interest  in  this 
field,  and  so  be  able  to  develop  in  the  course  of  a  few  years  a  sub- 
stantial national  program  for  the  child  that  will  be  one  of  the  glories 
of  this  country." 


n FLORIDA   STATE    BOARD    OF   HEALTH 

CHILD   HYGIENE  AND   PUBLIC   HEALTH   NURSING 

A  luncheon  at  the  Bureau  of  Home  Economics  was  followed  by 
a  field  trip  to  the  Child  Research  Center  at  1635  Columbia  Road. 
Moving  pictures  of  the  routine  of  the  child's  day  (child  from  two  to 
four)  together  with  certain  scientific  studies  in  child  life  the  staff  is 
now  carrying  on,  featured  this  trip.  At  the  dinner  conference.  Dr. 
Furnos,  Assistant  Commissioner  of  Health  in  Porto  Rico,  showed  an 
excellent  moving  picture  of  certain  phases  of  their  public  health  pro- 
gram prior  to  the  disaster.  Hie  eradication  of  hookworm  and  malaria 
and  the  improvement  of  infant  welfare  were  particularly  stressed. 

The  second  day's  conference  was  spent  in  ^siting  three  very 
successful  infant  welfare  centers  conducted  by  the  County  Unit  of 
Arlington  County,  Virginia,  and  in  hearing  Dr.  William  A.  White  of 
St.  Elizabeth's  Hospital  on  the  subject  of  "Mental  Hygiene".  A 
tea  at  the  White  House  closed  the  day's  program. 

At  the  Children's  Bureau  Saturday  morning,  William  C.  Carr 
of  the  United  States  Bureau  of  Education  discussed  "Methods  of 
Equalization  of  Local  Services';  Dr.  J.  H.  Mason  Knox,  Director  of 
the  Bureau  of  Child  Hygiene  of  Maryland,  reported  the  results  of 
the  recent  mortality  survey  made  there  and  Dr.  Adelaide  Brown,  a 
practicing  obstetrician  of  many  years'  experience,  also  a  member  of 
the  Board  of  Health  of  California,  discussed  the  "Promotion  of  a 
Maternity  and  Infancy  Program  in  a  County  Health  Department". 

In  subsequent  issues  of  Health  Notes,  more  will  be  said  of  certain 
of  these  visits  and  discussions. 

BUREAU   OF   ENGINEERING 
Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

SPRING    HOUSE    CLEANING 

Are  you  prepared  for  spring  floods  and  high  waters  with  the 
possibility  of  a  plentiful  Anopheles  mosquito  crop  in  early  summer? 
Every  city  can  start  now  cleaning  out  ditches,  opening  up  drains, 
providing  quick  runoff,  and  connecting  up  depressions  so  that  the  heavy 
down-pours  will  get  away  quickly.  Every  farmer  puts  his  ditches  in 
shape  so  his  crops  will  not  get  drowned  out.  How  about  extending 
those  ditches  a  little  farther  this  year?  Our  city  fathers  can  see  to 
it  that  the  city  is  made  "spotless  town"  by  cleaning  up  the  old  gar- 
bage dump  or  incinerator  pile,  picking  up  the  discarded  automobile 
skeletons  and  hauling  them  to  a  pit  or  cutting  them  up  by  acetylene 
torches  and  then  getting  rid  of  them  by  sale  or  burial.  Pick  up  I 
Clean  up!  Spruce  up!  Keep  down  the  pesky  fly  this  year  by  re- 
moving all  filth  from  the  barns,  stables,  etc.  Clean  up  the  privy  by 
building  a  new  State  Board  of  Health  type  privy.  Don't  delay  for 
on  this  one  thing  may  mean  the  life  of  your  children.  Hookworm 
and  typhoid  can  be  banished  by  the  sanitary  privy  and  modern  sanita- 
tion.    How  about  the  school?     Is  the  water  supply  safe  to  start  with, 


FLORIDA  STATE  BOARD  OF  HEALTH 73 

BUREAU    OF    ENGINEERING 

and  then  is  it  safely  distributed  to  the  children?  Have  they  put 
modern  plumbing  in  the  school  building  or  are  the  privies  properly 
built  and  kept?  Is  your  house  screened?  Think  over  the  safeguards 
that  protect  you  from  disease.  Are  there  any  weak  spots — weak 
links  that  disease  can  strike  through  and  hit  you  or  your  loved  ones? 

WATER    ANALYSIS 

Public  water  supplies  are  now  required  to  be  bacterially  examined 
at  least  once  a  month  by  the  State  Board  of  Health  at  the  Bureau 
of  Engineering  water  laboratory.  Strenuous  efforts  have  been  made 
to  drive  home  to  every  public  and  semi-public  water  supply  the  de- 
sirability of  having  at  least  a  monthly  check  on  their  water  and  we 
are  gratified  with  the  results.  By  educational  methods,  the  big  ma- 
jority of  the  suppliers  have  been  convinced  and  they  have  purchased 
their  standard  shipping  container  and  are  submitting  samples  every 
month.  Through  March,  1930,  we  have  run  1,480  bacterial  tests 
on  waters  of  Florida,  This  exceeds  the  entire  number  of  analyses  made 
in  the  year  1925.  Last  year  a  total  of  5600  tests  were  made — the 
greatest  number  ever  made  in  a  year  by  the  Bureau.  Is  your  water 
tested  regularly?      Ask  your  water  superintendent  1 1 

MOSQUITO  -  PROOFING  YOUR  HOME 

A  new  bulletin  is  just  off  the  press  carrying  the  above  title  and, 
in  brief,  it  is  a  bulletin  designed  to  make  plain  to  the  man  in  the 
country  just  how  he  can  make  his  home  mosquito-proof.  In  plain, 
simple  language  the  making  of  screen  doors  and  screened  windows 
is  outlined  together  with  a  description  of  the  materials  used,  etc. 

Attention  is  also  directed  to  papering  the  houses  so  as  to  exclude 
mosquitoes.  Details  are  given  as  to  the  protection  of  the  fire  place 
and  chimney  and  tin-stripping  openings  in  the  floor. 

But  why  mosquito-proof  the  home? 

Logical  procedure  would  be  to  keep  the  mosquitoes  from  breed- 
ing and  this  is  perfectly  possible  for  any  organized,  spirited  com- 
munity but  we  cannot  economically  bring  about  mosquito-free  counties 
without  excessive  costs  in  most  cases  and  so  we  reverse  the  aftack 
and  protect  the  dweller  from  the  mosquito.  The  bulletin  is  illustrated 
by  pictures  of  work  done  in  Florida  and  details  of  construction  of 
the  U.  S.  Public  Health  Service  type  screen  door.  You  can  get  a 
copy  by  writing  for  it.  Any  club,  group  or  community  can  have  a 
supply.  Ask  for  Engineering  Bulletin  No.  5.  Other  booklets  avail- 
able  for   the  asking  are:      "The  Sanitary  Privy,"    "The  Filthy   Fly," 

"Tourist  Camp  Sanitation,"  "The  Sewage  Treatment  Tank  (Septic 
Tank),"    "Mosquitoes  and  Mosquito  Control,"    "Malaria  Catechism," 

How  Typhoid  Fever  is  Caused." 


74  FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU    OF    COMMUNICABLE    DISEASES 
F.  A.  Brink,  M.  D.,  Director 

WHAT   OF   THE   SUMMER? 

Vacation  time  is  upon  us.  Our  college  men  and  women  are 
returning  from  months  of  toil  pouring  over  books;  soon  all  the  public 
schools  will  be  closed  and  our  young  people  will  be  in  a  changed 
environment  and  engaged  in  new  activities.  Some  will  be  in  military 
camps,  some  in  recreation  camps,  some  in  fishing  camps,  some  in 
auto  camps  and  some  (quite  a  few,  no  doubt)  will  stay  home  and 
sally  forth  as  often  as  possible  in  search  of  excitement  and  physical 
■well-being. 

The  outcome  of  all  this — whether  the  individual  will  profit  from 
the  vacation  or  be  a  loser — depends  quite  a  bit  on  preparation.  Va- 
cation is  like  a  football  game.  One  who  goes  into  it  without  proper 
training  and  equipment  may  expect  to  receive  some  painful  jolts. 

Vacation  Jolts 

SUNBURN  can  be  avoided  more  readily  than  it  can  be  cured. 
It  is  painful,  harmful  and  quite  unnecessary.  The  person  who  spends 
his  first  day  at  the  beach  or  lakeside,  basking  in  the  warm,  caressing 
(  ?  )  sunshine  clad  only  in  an  abbreviated  bathing  suit,  is  likely  to 
spend  a  week  in  misery,  clad  in  blisters  and  cold  cream.  The  slanting 
rays  of  early  morning  and  late  afternoon  are  relatively  harmless.  A 
much  better  tan  can  be  developed  by  gradually  increasing  exposures, 
the  pleasures  of  vacation  are  not  so  rudely  interrupted  and  one  avoids 
the  appearance  of  having  poor  judgment. 

CREEPING  ERUPTION  may  be  acquired  by  lying  or  sitting  on 
damp  ground  or  wading  in  pools  contaminated  with  the  excrement  of 
cats  and  dogs  that  have  hookworm.  The  hookworm  eggs  hatch  in  the 
soil  and  the  baby  worms  enter  the  skin  where  they  provoke  this  very 
distressing  eruption.  The  veterinarian  can  rid  the  cats  and  dogs  of 
their  worms  or  the  Humane  Society  can  put  them  to  sleep  (the  cats 
and  dogs).  Humans  can  avoid  intimate  contact  with  soil  frequented 
by  these  domestic  animals  or  they  can  take  a  chance  and  perhaps 
suffer  very  unpleasant  consequences. 

DROWNING  is  said  to  be  an  easy  way  to  die  but  the  pulmotor 
will  not  put  life  into  a  dead  person  and,  while  it  is  quite  a  pleasure 
to  show  off  in  the  water  it  is  no  credit  to  a  boy  or  girl  if,  by  reason 
of  cramps  or  something  he  goes  to  the  bottom.  Most  drownings  are 
the  result  of  taking  needless  risks. 

AUTOMOBILE  ACCIDENTS  can  be  avoided  foe.  the  most  part 
by  careful  driving.  The  driver  who  allows  his  attention  to  be  diverted 
from  his  driving,  who  exceeds  a  safe  speed  limit,  who  approaches 
curves,  crossroads  or  railway  crossings  carelessly,  who  takes  chances 
in  passing  other  cars  or  neglects  to  see  that  his  car  is  in  good  order, 
particularly  the  brakes,  is  a  menace  to  himself,  his  fellow  motorists 
and  everybody  who  may  be  on  the  highways. 


FLORIDA  STATE  BOARD  OF  HEALTH 75 

BUREAU    OF    COMMUNICABLE    DISEASES 

COMMUNICABLE  DISEASES  are  more  a  menace  in  vacation 
time  because  of  varied  water  and  food  supplies  and  more  numerous 
and  varied  contacts  with  possible  carriers.  The  vacationist  will  profit 
by  avoiding  such  things  as  the  common  drinking  cup,  doubtful  water 
and  food,  and  mingling  needlessly  with  dense  crowds.  The  simple 
measure  of  washing  the  hands  carefully  before  eating  will  afford  ad- 
ditional protection.  Vaccination,  typhoid  shots  and  diphtheria  im- 
munity .are  well  worth  having. 

POISON  IVY  can  be  recognized  and  avoided.  One  not  familiar 
with  the  plant  should  shun  all  three-leafed   vines. 


Florida  has  enjoyed  almost  complete  freedom  from  smallpox 
for  more  than  a  year  and  a  half.  Diphtheria  and  typhoid  prevalence 
has  been  the  lowest  in  years.  Measles,  mumps,  whooping  cough  and 
chickenpox  have  been  more  prevalent  than  usual  .  For  the  good  of  ■ 
Florida  we  want  to  reduce  to  the  minimum  all  communicable  diseases. 
The  doctors  who  report  their  cases  and  see  that  their  patients  do 
not  spread  disease  will  be  doing  a  splendid  service  to  their  communi- 
ties and  to  the  State.  *B 

TEACHERS   COOPERATE 

Some  teachers  urge  their  pupils  to  accept  the  protection  (im- 
munization) offered  by  the  State  Board  of  Health.  Some  will  even 
go  so  far  as  to  write  a  note  to  the  parents  urging  them  to  sign  the 
request  slips  so  the  children  can  be  inoculated.  There  are  still  a 
few  teachers  who  do  not  believe  in  immunization  and  the  health  of- 
ficer can  recognize  one  the  moment  he  enters  her  school.  Any 
teacher  who  by  word  or  deed  prevents  a  child  from  being  immunized 
is  morally  responsible  if  that  child  contracts  the  disease  from  which 
he  should  have  been  protected. 

BROADCASTING   GERMS 

We  know  a  man  who,   during  an  epidemic,    refused   to  use  the 
phone  for   fear   of  contracting  infection.      Much   is   transmitted   now 
by  wire   and   by   wireless   but   germs   travel   no    farther   or    faster    than 
their  human  hosts. 

Influenza,  the  swiftest  traveling  disease  known,  moves  only  as 
fast  as  the  speediest  means  of  human  transportation  which,  in  Osier's 
time,  was  the  passenger  train,  and  now  would  be  the  airplane.  (And 
the  airplane  is  something  health  officers  must  reckon  with.) 

Isolation  of  the  sick,   hygienic  care,   mosquito  control,  sanitation 
and  immunization  are  yet  the  recognized   measures   for  disease   con-    - 
trol.     We  do  not  have  to  cut  the  telephone  wire  or  turn  off  the  radio 
to  prevent  measles. 


76 


FLORIDA    STATE   BOARD    OF   HEALTH 


BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

DEATHS— 1929 

Last  year,  18,155  deaths  'were  registered  in 
this  state.  The  fact  that  the  number  of  deaths  did 
not  increase  over  the  previous  year  is  not  a  sur- 
prise to  those  who  have  been  watching  conditions 
closely.  Registration  is  just  as  complete  and  ac- 
curate as  ever,  if  not  more  so.  In  the  writer's 
opinion,  it  is  not  because  of  abnormally  better  con- 
ditions that  such  a  marked  decrease  over  the  year 
1926  has  been  recorded.  When  the  official  totals  on  population  are 
available  from  the  United  States  Bureau  of  the  Census,  which  is  under 
way  as  this  Health  Notes  goes  to  press,  it  will  not  be  surprising  to 
find  that  where  certain  cities  and  counties  have  been  expecting  popu- 
lation figures  to  indicate  a  rapid  growth,  they  will  not  go  over  the 
1925  state  census  very  much,  if  any.  This,  of  course,  is  a  forecast 
although  based  on  a  conservative  survey  of  many  influencing  factors. 


u 

1 

RECORDS ■ 

.^^1      I^Ki 

FLORIDA 

■ 

MAKE  NUTS  PART  OF  DAILY  MENU 

Nuts  should  be  used  as  a  food,  not  as  a  dainty.  Lulu  G.  Graves, 
well  known  dietitian,  advises  in  an  article  on  nuts  in  the  March  issue 
of  Hygeia,  the  health  magazine  published  by  the  American  Medical 
Association. 

Nuts  have  a  high  protein  and  fat  content  and  may  be  used  as 
a  substitute  for  meat,  eggs,  cheese  and  fish,  according  to  Miss  Graves. 
A  few  nuts  added  to  almost  any  salad,  dessert  or  casserole  dish  will 
improve  it  and  will  add  considerably  to  the  food  value.  Nuts  in 
sandwiches,    rolls  and   bread   are   always   well   liked. 

Here  is  a  recipe  suggested  by  Miss  Graves:  sweet  potatoes  may 
be  boiled,  mashed  and  seasoned  with  butter,  milk,  salt  and  cinnamon. 
Then  add  a  cup  of  walnuts  (to  eight  potatoes)  and  turn  into  a  baking 
dish.  Cover  with  marshmallows  and  bake  until  the  marshmallows 
are  golden  brown  and  puffy.     Serve  immediately. 


BRAN  MUFFINS  SUITABLE  FOR  DIABETIC  PATIENTS 

The  following  recipe  for  bran  muffins  is  one  of  a  number  suitable 
for  persons  with  diabetes  given  in  an  article  by  C.  D.  Christie  and  E. 
M.  Geraghty  in  Hygeia: 

Take  3  eggs,  2  tablespoons  butter,  1  level  teaspoonful  soda,  2 
cups  washed  and  dried  bran,  1  cup  sour  milk  or  buttermilk  and  Yi 
teaspoonful  salt. 

Beat  egg  yolk.  Melt  butter  and  add  to  egg  yolk.  Mix  soda 
and  bran.  Add  bran  and  soda  mixture  alternately  with  sour  milk  to 
the  egg  yolk  and  butter.  Add  salt  to  egg  whites.  Beat  egg  white 
and  fold  into  other  materials.  Put  into  muffin  tins  greased  with 
mineral  oil.  Bake  in  hot  oven  until  done.  This  makes  twelve  muffins 
weighing  30  Gm.  each  and  giving  approximately  the  following  food 
value  for  each  muffin:  protein,  2  Gm.;  fat,  4  Gm.;  carbohydrate,  1 
Gm.;  calories,  46. 


FLORIDA    STATE   BOARD    OF   HEALTH 


77 


BUREAU  OF  VITAL  STATISTICS 

WHAT  DOCTORS  HAVE  DONE  FOR  CHILDREN 

Never  in  the  history  of  the  world  have  children  been  cared  for 
with  such  tender  consideration  as  in  the  present  era.  To  many  of  us 
it  may  not  occur  that  children  have  not  always  been  so  happy  or 
so  healthy  as  they  are  now.  In  the  March  issue  of  Hygeia  Dr.  John 
A.  Foote  traces  the  story  of  the  child  health  movement  and  the 
physician's  part  in  it. 

Children  died  from  smallpox  by  the  thousands  until  Jenner  dis- 
covered vaccination.  Pasteur  was  not  a  physician,  but  the  process 
of  killing  germs  in  milk  which  bears  his  name  has  saved  incalculable 
numbers  of  children.  Robert  Koch's  discovery  of  the  germ  of  tuber- 
culosis has  made  it  possible  to  lower  the  death  rate  from  200  to 
50  per    100,000  in   twenty-six  years. 

Roux,  von  Behring,  Schick,  Park  and  Zingher  are  illustrious 
names  that  stand  for  the  eradication  of  diphtheria.  The  work  of  the 
Dicks  in  scarlet  fever,  of  Huldschinsky  and  Hess  in  the  prevention 
of  rickets  by  sunlight  and  cod  liver  oil,  of  Holt  and  Howland  and 
Marriott  in  infant  feeding — these  are  only  a  few  of  the  great  number 
that  have  contributed  to  the  present  safety  and  welfare  of  children. 
Every  city  and  county  health  department  has  its  unknown  heroes  who 
are  doing  their  share  of  this  vast  work  of  saving  children. 


NEW  LOCAL  REGISTRARS  APPOINTED 

Address 


District 

No.           Name 

3-04 

Mrs.  Lyda  L.  Sharpe 

6-07 

Thos.  C.  Moore 

8-02 

John  J.   Brown 

11-07 

Rothwell  Lefholz.  M.  D 

14-207 

Mrs.  Nellie  Edwards 

22-01 

Mrs.  H.  F.  McClellan 

23-01 

R.  S.  Green 

27-02 

W.  B.  Brantley 

33-01 

Miss  M.  W.  Starbuck 

35-07 

Miss  Agnes  Moremen 

37-10 

Miss  Audrey  Purdom 

39-06 

Hampton  E.  Pedigo 

44-247 

Miss  Nannie  B.  Graham 

49-01 

Peter  Garside,  M.  D.  C. 

51-117  Mrs.  Mollie  Jernigan 

57-01  Hon.  R.  C.  Vorhees 

64-02  Mrs.  Mary  Roberts 

67-01  J.  E.  Morris 


Lynn  Haven,  Fla. 

Oakland  Park,  Fla. 

Box  23,  Homosassa,  Fla. 

New  City  Hall,  Coral  Gables,  Fla. 

Century,   Fla. 

Box  236,   Monticello,  Fla. 

Mayo,   Fla. 

Williston,  Fla. 

15   N.   5  th  St.,   Fernandina,   Fla. 

Maitland,   Fla. 

Box  84,  Boca  Raton,  Fla. 

Safety  Harbor.  Fla, 

Harold,  Fla. 

237  S.  Grand  view  Ave.. 

Daytona  Beach,  Fla. 
Freeport,   Fla. 
Moore  Haven,  Fla. 
Bell,   Fla. 
Box  878,  Stuart,  Fla. 


78 


FLORIDA  STATE  BOARD  OF  HEALTH 


6. 

7, 

55. 

8. 

9. 


BUREAU  OF  VITAL  STATISTICS 

Total  Deaths  by  Color  and  by  Counties,    1929 


COUNTIES 

DEATHS 

Total 

White 

Colored 

0. 

1. 

? 

State 

Alachua __ 

Baker.....  ...  _. 

18,155 
480 
92 
132 
108 
161 

10,860 
228 
55 
96 
68 
90 

7.295 

252 

37 

3 

Bay 

36 

4 

Bradford 

40 

5. 

Brevard 

7! 

10. 

11. 

12. 
56. 
13. 

14. 

53. 

15. 
16. 

64. 
57. 
65. 

17. 
58. 
63. 
18. 
59. 
19. 

20. 
66. 
21. 


Broward... 

Calhoun 

Charlotte 

Citrus 

Clay.. 


62.     Collier.. 


Columbia... 
Dade_„— 

DeSoto 

Dixie.. 
Duval 


Escambia.. 
Flagler. 


Franklin 

Gadsden*... 

Gilchrist 

Glades. 

Gulf 

Hamilton — __ 

Hardee 

Hendry. _ 

Hernando 

Highlands 

Hillsboro„...~_ 

Holmes. 

Indian  River.. 
J  a  ckso  n 


214 

118 

96 

69 

52 

17 

33 

29 

4 

67 

33 

34 

97 

60 

37 

15 

13 

2 

248 

138 

110 

1,372 

958 

414 

134 

95 

39 

102 

66 

34 

2.379 

1.136 

1,243 

652 

411 

241 

26 

11 

15 

56 

22 

34 

791 

340 

451 

43 

31 

12 

26 

16 

10 

31 

21 

10 

121 

65 

56 

61 

67 

14 

43 

23 

20 

57 

39 

18 

110 

58 

52 

1.599 

1,116 

483 

110 

101 

9 

60 

34 

26 

386 

215 

171 

*State  Hospital  Inmates  Included. 


FLORIDA  STATE  BOARD  OF  HEALTH 


79 


BUREAU  OF  VITAL  STATISTICS 

Total  Deaths  by  Color  and  by  Counties,    1929.      (Continued) 


COUNTIES 

DEATHS 

Total 

White 

Colored 

22. 

Jefferson    

226 

45 

181 

23. 

Lafayette 

25 

16 

7 

24. 

Lake „,  -  

253 

165 

66 

25 

Lee 

J37 

88 

49 

26. 

Leon.   - 

259 

96 

163 

27. 

Levy...... „ 

151 

82 

69 

28. 

Liberty. , 

51 

35 

16 

29. 

Madison. 

203 

91 

112 

30. 

Manatee 

263 

161 

102 

31. 

Marion , 

452 

197 

255 

67 

Martin 

49 

29 

20 

32. 

Monroe — 

192 

136 

56 

33. 

Nassau 

121 

43 

78 

34. 

Okaloosa 

100 

86 

14 

54. 

Okeechobee 

31 

20 

11 

35. 

Orange 

685 

491 

194 

36 

Osceola 

190 

133 

57 

37. 

Palm  Beach. 

512 

293 

219 

38. 

Pasco 

168 

131 

37 

39. 

Pinellas _... 

793 

654 

139 

40. 

Polk - 

731 

503 

228 

41. 

Putnam 

292 

124 

168 

42. 

St.  Johns * 

277 

164 

113 

43. 

St.  Lucie 

75 

46 

29 

44. 

Santa  Rosa -.. 

122 

75 

47 

60. 

Sarasota. 

133 

93 

40 

45. 

Seminole 

243 

1  14 

129 

46. 

Sumter 

102 

57 

45 

47. 

Su  wann  e  e 

181 
161 

109 
87 

72 

48. 

Taylor .. 

74 

61. 

Union 

96 

36 

60 

49. 

Volusia. 

607 

397 

210 

50. 

Wakulla. 

67 

39 

26 

51. 

Walton 

181 

130 

51 

52. 

Washington 

131 

85 

46 

BO 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


'BILL  JONES  OOMEcSHOME- 


MnsHi's  been  a.  IoikJ  wait  for  you  to 
come  home  from  the  .sanrtarium.Bill.' 
Billi'les,  ini  if  I  hadat  $one  before  I  really 
$ot  sick,  I  might  not  have  come  home  atm 


AT  THE  OFFICE) 

^*\       f* 

^S     *^N 

$j!l4 

m™          art^^k    Jim 

r 

LDDk 

y 

3i 

IK 

ery  body:-  Gee,  ] 
du  really  have 
Ei'Y«.butIfo 
w  I  feel  bette 

SiU.yoii  1ook< 
,  tuberculos 
und  it  out  in  1 
r  than  I  have  I 

[reat;  did 
is?" 

i  me  and 

Bilh-'l  had  a  narrow  escape,  Do^  that 
examination  yxi  gave  me  saved  my  life! 


A  Fable 


ONCE  upon  a  time  there  was  a  city  with  a  street  running 
along  a  high  cliff.  In  dark  and  stormy  weather  so 
many  people  were  injured  by  falling  over  the  edge 
that  the  citizens  gathered  together  to  see  what  they  could 
do  about  it.  After  much  debate  they  decided  to  increase  their 
taxes  and  build  a  hospital  at  the  foot  of  the  cliff  so  the  injured 
might  receive  immediate  attention. 

Now,  it  chanced  that  a  great  physician  visited  the  city 
and  the  officials  showed  him  the  hospital  with  great  pride.  But 
he,  looking  up  at  the  cliff,  said:  "Wouldn't  it  have  been  better 
to  build  a  wall  along  the  cliff  so  the  people  couldn't  fall  off?" 

Moral:    Prevention  is  better  than  cure,  and  much  cheaper 
in  both  lives  and  money. 

©  a.  p.  H.  A. 


This  laaue  Exceeds   1  1.000  Copies 


pLORIDA 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY,    1692 

STATE  BOARD  OF  HEALTH 


Entered  ••  Second  dee*  Matter.  October  27.   1911 
•t   tbe   PoatofHu  at   Jacksonville.    Flo  ride.   Under   the  Act   of   August    24.    1913 


JACKSONVILLE,  FLORIDA 

red  as  Second  Clou  Matter.  October  27. 
t   Jacksonville.    Florida,   Under   tbe  Act   t 

This  Bulletin  will  be  sent  to  any  address  in  the  State  free  of  charge. 

Vol.  22  JUNE.  1930  No.  6 


Edited  by 
STEWART  C.  THOMPSON.  D.P.H..  Member 

American   Medical    Editors*  and    Authors*  Assn. 


SPECIAL  ARTICLES  ' 

MALARIA— Eaton 

THE  TAX  OF   DISEASE— Brink 

NEW    SCHOOL  BUILDINGS— FUby 

WHITE    HOUSE    CONFERENCE— Blachly 

STATE  HEALTH   WORKERS  ORGANIZE— Hanson 

NATURAL    INCREASE    OF    POPULATION— Thompson 


HENRY  HANSON.  M.  D..  STATE  HEALTH  OFFICER 


82 


FLORIDA    STATE    BOARD    OF    HEALTH 


Chas.    H.    Mann.    Pres,' 
Jacksonville 


BOARD    MEMBERS 

H.    Mason    Smith.    M.    D. 
Tampa 


Wm.  D.   Noble*.   M.  D. 
Penjtacola 


STATE  HEALTH  OFFICER 

Henry   Hanson,    M.    D. 


BUREAUS  AT  JACKSONVILLE 


DIRECTORS 


Diagnostic   Laboratories . — „ Paul  Eaton.  M.  D-.  D.  P.  H. 


■Vital    Statistics. 
Comrnunicable   Diseases-, 
Engineering- 


Chlld  Hygiene  and  Public  Health  Nursing 

Accounting 

Crippled   Children 


Stewart   C.  Thompson.  D.  P.   H. 
F.  A.  Brink.  M.  D. 
Ellsworth  L.   Filey.  C  ,E. 
Lucile    Spire     Blaehly,    M.    D. 
Screven   Dozler 
F.    L.   Fori.   M.  D. 


■5  50   Local  Registrars    (County   Uat   furnished   on  request). 

*  Registration     Inspector..^.— .... Anna  C.  Emmons 

Drug  Store  Inspector , H.   R.   Monroe 


Drug;    Store    Inspector 


W,   A.   Mahoney 


LABORATORIES 


Jacksonville- 

*liami... 


Pensacola  .. 

Tallahassee 

Tampa —_- 


Pearl    Griffith.    B.    E. 

E.  R.    Powell 

„-„__-_  Jane    B.   Currie,    B.   S. 

_    Elizabeth   Byrd.  B.  3. 

H.    D.    Venters.    B.    3. 


MEDICAL   OFFICERS 


DeFuniak    Springs 

lacksonvilie 

Vcro    Beach 

Tallahassee 

Tampa — — — -_ 


C.    W.    McDonald.    M.    D. 
B.  C.   Wilson.  M.   U 
W.   A.    Clanlon,    M.    D. 
A.   P.   Harri»r>n.   M.   D 
A.   C.   Hambtin,    M.   D. 


DISTRICT   SANITARY   OFFICERS 


Tampa . * — 

Jacksonville.. 
Miami - 


Ocala  -—_-    

Orlando 

Puma  Gorda 
Tallahassee — 


Tampa 


■V,  B.  Lamoureux.  C.   E. 
.    Fred  A.  Safay 
George   B.   Reed 
C.  A.   Holloway 
Russell   Bronghmaa 
-    G.  A.  Renney 
C.  N.  Hobbs 
.    D.  H.  Osburn 
'Assistant  Engineer 


PUBLIC   HEALTH   NURSES 


Lake  City- 
Tampa.^, - 

Arcadia.. 


DeFuniak  Springs 

Eden,  R.    F.    D.    Jensen.. 
Lake    City 

M  a  d  i  son. -™~ 

Ruskin 

Starke. .__-____, 


'Clio    McLauRhlin,    R.    N. 
•Harriet    ).  Sherman,   R.   N. 
„   Jule    Craves,   R.   N. 
...  Nanna   Colby,   R.    N. 

Sarah   Ida    Richards.   R.   N. 
Frances  Hall,  R,  N 
Thora    Roberts.   R.  N. 
-  Joyce   Ely.   R.   N, 
Mary  G.   Dodd.   R.   N. 

'Field    Supervisor 


FLORIDA  STATE  BOARD   OF  HEALTH 83 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

STATE    PUBLIC    HEALTH    ASSOCIATION 

At  Gainesville  on  May  1st  and  2nd  moat  of  the  employees  of 
the  State  Board  of  Health  and  representatives  of  several  City  Health 
Departments  met  to  consider  the  formation  of  a  Public  Health  As- 
sociation to  be  composed  of  persons  actively  engaged  in  public  health 
work  in  Florida.  Owing  to  short  notice  many  of  those  engaged  in 
county  and  city  health  work  did  not  attend.  Some  of  these  had 
misunderstood  the  notice  and  thought  that  because  they  did  not  re- 
ceive personal  invitations  they  were  not  entitled  to  take  part  in  the 
meeting.  Such  an  impression  is  erroneous  as  it  was  the  desire  of  the 
State  Health  Officer  to  have  in  attendance  all  persons  engaged  in 
public  health  work  whether  city,  county  or  state.  The  object  of  the 
meeting  was  primarily  for  a  round  table  discussion  of  the  problems 
of  preventable  diseases  which  are  met  from  day  to  day  by  those  ac- 
tively engaged  in  this  work.  It  is  hoped  that  all  interested  will  at- 
tend the  next  meeting,  which  will  probably  be  called  in  December 
in  Jacksonville  when  the  organization  will  be  completed  and  a  con- 
stitution  and  by-laws  adopted. 

The  question  of  a  name  for  the  organization  was  discussed  to 
some  extent  and  it  was  suggested  that  the  present  Florida  Public 
Health  Association  resume  the  name  which  it  formerly  had  "Florida 
Anti-Tuberculosis  Association"  or  some  such  name  as  the  "Health 
and  Tuberculosis  Association"  under  which  it  can  continue  very  valu- 
able work  quite  as  effectively  as  under  its  present  name.  This  would 
eliminate  much  confusion  which  has  arisen  as  some  have  taken  its  name 
to  mean  that  it  is  a  part  of  the  official  health  agencies  of  the  state. 

The  object  of  this  new  organization  is  more  specifically  for  the 
discussion  of  scientific  problems  in  health  work  both  from  a  labora- 
tory nature  and  as  they  are  met  in  the  field.  The  new  organization 
will  sponsor  in  every  way  possible  the  activities  of  the  Tuberculosis 
Association  and  lend  its  moral  support  in  every  way  possible  to  the 
Christmas  Seal  Sale  and,  in  any  other  way  in  which  it  can,  co-operate 
with  the  group  which  is  more  especially  interested  in  the  general 
tuberculosis  problem. 

From  the  standpoint  of  the  writer  it  would  seem  that  it  is  very 
important  that  those  interested  in  tuberculosis  should  not  delay  in 
establishing  their  identity  under  a  name  which  expresses  more  specific- 
ally their  main  objective.  At  the  meeting  referred  to  a  motion  was 
made  and  seconded  that  the  official  group  organize  under  the  name 
of  the  "State  Public  Health  Association,"  but  definite  action  was  de- 
layed pending  such  time  as  the  present  Florida  Public  Health  Asso- 
ciation may  need  to  decide  what  it  wishes  to  do  in  the  matter  of 
change  of  name. 

The  State  Health  Officer  was  elected  temporary  chairman  of  the 
new  organization  and  Dr.  Stewart  Thompson,  secretary. 


84 FLORIDA   STATE  BOARD   OF   HEALTH 

ADMINISTRATION 

The  health  workers'  group  manifested  great  interest  and  a  very 
lively  discussion  took  place  in  connection  with  the  impromptu  pro- 
gram, 

FLORIDA    HEALTH    PROBLEMS    AND 
THE   HEALTH   COUNCIL 

The  magnitude  of  the  Florida  Health  Problems  and  their  rela- 
tion to  the  Health  Council  .are  such  that  one  can  only  outline  briefly 
those  which  should  receive  first  consideration. 

Geographically,    Florida,    as   a   whole,    lies   between    3 1    degrees 
and   24  degrees  North  Latitude;   consequently,   its  most  southern  ex- 
tremity is  only  one-half  degree  north  of  the  Tropic  of  Cancer.      Flor-  f 
ida  has  temperate,  sub-tropical  and  tropical  climates  and,  consequent- 
ly,   health   problems   characteristic    of   each    of    these. 

Among  the  health  problems  characteristic  of  temperate  climates 
we  have  tuberculosis,  typhoid,  diphtheria  and  the  usual  run  of  con- 
tagious diseases.  Among  those  commonly  designated  exanthemata, 
the  diseases  show  a  tendency  to  mildness  characteristic  of  the  tropical 
climates.  As  one  approaches  the  tropics,  scarlet  fever  and  diph- 
theria as  well  as  smallpox  grow  milder  and  scarlet  fever  is  often  so 
mild  that  it  is  difficult  to  recognize.  Among  the  water-borne  dis- 
eases of  which  typhoid  is  an  example,  there  has  been  a  satisfactory 
progressive  decline  during  the  twenty  years  that  I  have  been  fa- 
miliar with  the  conditions  of  the  state.  This  is  due  in  a  large  meas- 
ure to  safe-guarding  methods  instituted  by  Mr.  Filby  of  our  Bureau  of 
Sanitary  Engineering  as  well  as  a  natural  supply  of  pure  underground 
water,  in  most  places  supplemented  by  an  intensive  immunizing  cam- 
paign conducted  by  our  Bureau  of  Communicable  Diseases  under  the 
direction  of  Dr.  Brink.  Smallpox  continues  sporadic  and  will  do  so 
until  our  people  conclude  that  they  do  not  wish  to  have  this  disease. 
Smallpox  is  a  disease  of  personal  choice  and  only  those  who  want 
it,  have  it. 

Our  tuberculosis  problem  is  of  some  importance,  but  it  is  no  worse 
than  in  other  states  and  it  shows  a  more  satisfactory  rate  than  that 
of  many.  For  example,  the  provisional  figures  for  the  calendar  year 
of  1926  show  a  rate  of  73  per  100,000  population.  45.9  for  the 
whites  and  134.3  colored.  Our  total  deaths  for  the  year  1929, 
(provisional  figures),  were  1,014,  of  which  416  were  among  the 
whites  and  598  among  the  colored.  The  typhoid  deaths  show  a 
total  for  the  state  of  83,  among  the  whites  38  and  45  among  colored. 
Owing  to  the  fact  that  the  present  census  figures  are  incomplete,  no 
rates  are  given  for  the  year    1929. 

Diphtheria  has  decreased  until  we  are  soon  approaching  that 
theoretical   point   beyond   which   we    will    make   no    continued    further 


FLORIDA  STATE  BOARD   OF  HEALTH 85 

ADMINISTRATION 

reduction.  Theoretically,  it  should  be  possible  to  eliminate  diph- 
theria from  our  causes  of  deaths,  but  actually,  so  long  as  we  con- 
tinue to  have  those  with  us  who  do  not  believe  in  the  germ  theory 
and  substitute  prayers  or  absent  treatment  for  toxin  an ti- toxin,  or 
manipulate  spines  when  anti-toxin  should  be  given,  we  will  continue 
to  sign  death  certificates  for  babies  and  diphtheria  will  be  the  cause. 

Tampering  with  health  and  sickness  is  another  of  the  serious 
problems  of  the  state.  The  laws  which  should  protect  our  people 
against  the  unscrupulous  exploiter  of  the  sick  are  too  lax;  persons 
inadequately  prepared  are  permitted  to  practice  the  healing  art,  not- 
withstanding the  fact  that  they  leave  behind  impoverished  victims 
who  continue  to  suffer,  or  are  responsible  for  the  erection  of  a  series 
of  tombstones  as  mute  testimonials,  monuments,  to  their  skill  and 
integrity.  Our  maternal  death  rate,  the  highest  in  this  country,  gives 
us  no  cause  for  pride,  nor  do  we  boast  of  having  seventeen  male 
mid  wives.  These  are  matters  to  which  the  Health  Council  may  well 
give  serious  thought. 

Aside  from  the  outstanding  specific  problems  affecting  both  the 
health  and  the  economic  condition  of  the  state,  there  are  those  of 
malnutrition  and  in  using  the  term  "malnutrition"  here  I  have  in  mind 
the  improper  diets  observed  in  many  sections  of  our  rural  communi- 
ties for  both  adults  and  children.  It  is  strange  that  in  a  country 
where  both  climate  and  soil  favor  liberal  variety  of  produce  so  few 
vegetables  are  grown  and  a  comparatively  very  few  people  have  a 
sufficient  amount  of  milk.  People  who  are  not  adequately  nourished 
become  a  prey  to  infectious  and  debilitating  diseases  and  make  slow 
and  poor  recoveries  when  under  treatment.  It  often  appears  that 
the  foundation  on  which  to  build  is  lacking  owing  to  the  fact  that 
the  people  d^libt  produce  the  variety,  quality  and  quantity-  of  food 
needed. 

In  the  tuberculosis  problem,  the  Health  Department  is  more  in- 
terested in  prevention  than  cure  and  so  long  as  no  adequate  pro- 
vision exists  for  the  protection  of  children  against  infection,  spread 
of  bacilli  by  the  careless,  advanced  cases,  whether  indigent  or  other- 
wise, will  cause  these  young  children  to  continue  to  become  infected 
and  complete  the  vicious  cycle  of  more  advanced  hopeless  indigent 
cases. 

The  immediate  outstanding  problems  which  have  received  con- 
siderable discussion  of  late  are  those  of  the  prevalence  of  malaria  and 
hookworm.  From  the  health  standpoint,  the  452  deaths  reported 
from  malaria  last  year  mean  that  there  were  something  like  90,400 
persons  who  had  malaria  in  the  state  during  1929.  Our  laboratory 
statistics  show  that  25%  of  all  colored  children  examined  had  hook- 
worm and  28%  of  the  white  children  as  examined  in  the  central  lab- 
oratory had  the  disease.      This   includes  a   large  number  of  negative 


\ 


96 FLORIDA  STATE   BOARD   OF  HEALTH 

ADMINISTRATION 

specimens  taken  from  cities  where  hookworm  disease  is  rare.  Sur- 
veys taken  from  country  districts  have  shown  a  variation  of  from  25% 
to  80%  of  those  examined  to  carry  the  eggs  of  hookworms.  These 
diseases  are  tropical  and  the  most  debilitating  with  which  we  have  to 
deal.  An  individual  having  malaria  during  the  acute  attack  is  en- 
tirely incapacitated  for  work  and  when  the  disease  becomes  chronic 
his  efficiency  drops  to  about  50%.  In  the  case  of  the  hookworm 
sufferer  who  actually  has  the  disease  the  efficiency  is  usually  about 
33%.  If  one  should  go  back  to  calculate  on  a  financial  basis  what 
the  loss  is  to  the  state  from  malaria  one  would,  on  the  most  conserva- 
tive basis,  be  obliged  to  give  not  less  than  five  days  total  loss  in  earn- 
ing capacity  for  each  of  the  90,400  who  had  the  disease,  or  a  total 
of  452,000  working  days  lost.  If  one  calculates  a  man's  working 
year  as  300  days,  this  would  mean  that  one  man  would  have  to  work 
1,506  years  to  make  up  for  the  time  lost  during  the  one  year  1929, 

The  menace  from  the  spread  of  hookworm  disease  is  equally 
appalling  in  that  each  female  worm  can  deposit  9,000  eggs  during 
each  24  hours  and  the  number  of  worms  in  the  individual  varies,  ac- 
cording to  whether  or  not  he  has  a  simple  hookworm  infestation  of 
from  25  to  30  or  40  worms  or  whether  he  is  actually  a  sufferer  of 
the  disease  where  he  may  harbor  200  worms.  We  find  that  one  in- 
dividual may  put  out  from  300,000  up  to  2,000,000  eggs  per  day, 
which  develop  into  infective  larvae  ready  to  penetrate  the  skin  on 
the  feet  of  the  children  who  run  barefooted  about  these  rural  homes 
where  the  sanitary  toilet  facilities  are  not  in  existence. 

Time  does  not  permit  us  to  go  into  more  extended  detail,  but 
it  becomes  apparent  that  there  is  a  very  definite  and  decided  func- 
tion for  the  Health  Council  in  the  sponsoring  of  activities  for  the  cor- 
rection of  the  most  glaring  of  the  defects  first,  and  then  of  the  com- 
paratively minor  but  also  important  problems  later. 

On  the  great  occasion  of  the  celebration  of  Dr.  Welch's  80th 
birthday  on  April  8th  one  paragraph  of  his  response  contains  the  fol- 
lowing: 

"While  public  health  is  the  foundation  of  the  happiness  and 
prosperity  of  the  people  and  its  promotion  is  recognized  as  an  im- 
portant function  of  government,  how  wide  is  the  gap  between  what 
is  achieved  and  what  might  be  realized,  how  inadequate  is  the  un- 
derstanding of  the  public  concerning  the  means  adapted  to  secure 
the  best  results,  how  small  the  attractions  offered  to  those  entering 
or  who  might  desire  to  enter  careers  in  public  health  through  lack  of 
suitable  financial  recompense,  of  security  of  tenure  of  office,  of  op- 
portunities for  promotion,  of  standa/ds  for  eligibility  based  upon 
special  training  and  experience,  and  of  funds  made  available  for  the 
public  promotion  of  health." 

On  this  occasion  President  Hoover  said: 


FLORIDA  STATE  BOARD  OF  HEALTH ^7 

ADMINISTRATION 

"No  valuable  change  in  everyday  practice  of  any  of  the  great  arts 
has  ever  been  made  that  was  not  preceded  by  the  accretion  of  basic 
truths  through  ardent  and  painstaking  research.  This  sequence  that 
precedes  effective  action  in  medicine  is  equally  important  in  every 
field  of  progress  in  the  modern  world.'* 

The  Health  Council  can  be  an  instrument  in  the  sequence  which 
is  to  precede  the  effective  solution  of  Florida's  health  problems,  in 
bringing  about  cooperation  and  coordination  of  effort  by  official  as 
well  as  n  on -official  agencies. 


ANONYMOUS   COMMUNICATIONS 

Anonymous  letters  are  received  occasionally.  Some  of  these 
have  worth-while  information  while  most  of  them  do  not,  and  are 
simply  the  expression  of  prejudice  and  spite  work  and  consist  of  an 
effort  to  get   someone  in   trouble. 

Naturally  such  letters  are  thrown  in  the  waste  basket.  If  a  let- 
ter is  worth  writing  it  is  worth  signing.  We  pay  no  attention  to  un- 
signed letters. 


NOW   IS  THE   TIME   TO   TEACH   VACATION 

HYGIENE 

Health  teaching  may  well  be  centered  about  vacation  plans  at 
this  time  of  year.  Prof.  J.  Mace  Andress  suggests  to  teachers  in  the 
monthly  school  department  which  he  conducts  in  Hygeia. 

Every  vacationist  is  subject  to  more  dangers  during  vacation 
than  he  would  be  at  home.  Students  should  be  trained  in  the  prin- 
ciples of  safety  to  meet  the  common  dangers  incident  to  traveling 
on  the  highways,  trains,  boats  and  on  foot.  When  accidents  occur 
they  should  know  the  right  things  to  do. 

Dangers  to  health  that  meet  the  vacation  seeker  may  lie  in  un- 
safe water  and  milk  supplies  and  often  in  insanitary  restaurants, 
fatigue  and  exposure.  Training  in  personal  and  community  hygiene 
is  the  best  protection. 


88  FLORIDA   STATE  BOARD   OF   HEALTH 


CHILD   HYGIENE   AND   PUBUC   HEALTH    NURSING 
Lucile   Spire   Blachly,    M,    D.,   Director 

CONFERENCE  STATE  MAY   DAY  CHAIRMEN 
(Continued) 

A  great  deal  is  now  being  said  and  written  about  mental  hygiene. 
Almost  everybody  with  the  urge  to  make  life  more  nearly  worth  liv- 
ing feels  called  upon  to  sponsor  a  movement  or  a  cause  or  a  reform 
or  something,  he  hardly  knows  what,  to  bring  about  this  happy  result. 
Rarely  does  the  reformer  recognize  the  fact  that  in  a  large  measure 
this  urge  in  itself  is  a  symptom  of  personal  maladjustment  and  its 
exercise  a  type  of  occupational  therapy.  The  popularity  of  the  move- 
ment is  evidence  of  its  all  but  universal  need.  This  interest  has  come 
through  recognition  of  the  fact  that  like  most  diseases,  mental  disease 
is   much   easier   prevented   than    cured. 

Dr.  William  A,  White.  Superintendent  of  St.  Elizabeth's  Hos- 
pital for  the  Insane,  Washington,  D.  C.  speaking  before  this  Confer- 
ence, briefly  traced  the  growth  of  the  movement  from  the  time  when 
an  attempt  was  first  made  to  improve  the  care  of  the  insane,  which 
led  to  the  query:  "Why  do  people  go  insane?,"  down  through  the 
interest  in  the  neurotic,  the  socially  mal-adjusted.  then  to  those  that 
are  merely  unhappy.  Now  it  is  found  where  adequate  set-ups  are 
available,  that  is.  trained  persons  working  together  in  groups,  they 
have  more  than  they  can  possibly  do.  Pretty  nearly  everybody  is 
more  or  less  unhappy,  he  said.  "The  aim  of  mental  hygiene,"  he 
continued,    "is  to  bring  about  efficiency,   contentment,   and  happiness. 

Mental  disease  as  seen  in  adults  is  only  an  end  product — an 

end  product  of  years  of  bad  living All  mental  maladies  begin 

in   childhood Trace  any  case   of   mental   disease   back  and   its 

origin  is  found  there."  He  went  on  to  say  that  mental  disease  is 
regressive.  It  is  due  to  certain  deficiencies  in  the  individual.  Cer- 
tain sections  in  his  development  remain  retarded.  He  reaches  adult- 
hood still  infantile  in  some  respects.  "In  putting  up  ■  fifty-story  build- 
ing considerable  attention  is  given  to  the  foundation.  In  building  hu- 
man beings,  too  much  has  been  left  to  chance." 

What  are  we  going  to  do  about  it?  Obviously  we  cant  ever 
expect  to  have  twenty-five-thousand-dollar-a-year  set-ups  scattered  all 
around  through  the  woods  and  over  the  prairies  to  prevent  these  mal- 
adjustments and  yet  that's  where  many  of  these  things  start.  Like  the 
weeds  and  the  inBects,  children  pop  into  being  in  the  most  unexpected 
places  and  at  the  most  inopportune  times.  They  are  lucky  if  they 
have  the  care  of  the  common  garden  variety  of  parents,  the  school 
teacher  who  is  filling  in  the  time  between  commencement  and  mar- 
riage, and  the  public  health  nurse  who  is  expected  to  give  more  or 
less  personal  attention  to  30,000  individuals  annually.  To  this  group, 
fortunately  for  an  increasingly  greater  number,  may  be  added  the  mod- 
ernly  trained  pediatrician  or  his  able  substitute,  the  family  physician, 

1930   model. 

In  a  later  issue,  something  of  the  part  each  or  these  may  play  m 
the  promotion  of  mental  hygiene  will  be  discussed. 


FLORIDA   STATE  BOARD   OF  HEALTH 89 

BUREAU    OF    DIAGNOSTIC    LABORATORIES 
Paul  Eaton,  M.  D.,  D.  P.  H.t  Director 

MALARIA 

In  a  drop  of  normal  human  blood,  the  size  of  a  pin  head,  there 
are  about  5,000,000  red  cells.  It  is  in  these  red  cells  that  the 
organism  which  causes  malaria  lives  and  multiplies. 

In  order  to  examine  the  blood  for  malaria,  the  physician  punc- 
tures the  skin  on  a  finger  or  an  ear  and  collects  a  small  drop  of  blood 
on  a  glass  slide  and  then  spreads  it  out  thin  so  that  the  red  cells  lie 
not  more  than  one  layer  thick  on  the  slide.  (There  is  a  thick  film 
method  but  it  requires  a  very  special  technique) .  The  cells  are  stained 
with  a  complicated  anilin  dye  and  are  then  ready  for  study  under 
the  microscope. 

Under  the  high  magnifying  power  of  the  microscrope  needed 
to  discern  the  malaria  parasite,  not  more  than  about  250  cells  can 
be  seen  in  any  one  microscopic  field,  that  is  in  the  part  of  the  glass 
slide  that  can  be  seen  under  the  microscope  at  any  one  time. 

Assuming  that  a  patient  is  anemic  from  malaria  or  from  some 
other  cause,  his  blood  will  contain  from  3,000,000  to  4,000.000  red 
cells  in  each  cubic  millimeter,  that  is.  in  a  drop  about  the  size  of  a 
pin  head.  A  little  calculation  will  show  that  at  any  one  glance  the 
microscopist  can  see  but 

250                       1 
or   1 of  the  whole  drop   of  blood  on  the  slide. 


4,000.000  16,000 

so  he  would  have  to  study  16  fields  or  4000  red  cells  in  order  to 
see  one  tenth  of  one  percent  of  the  small  drop  of  blood  which  was 
withdrawn  for  the  test.  When  it  is  further  considered  that  this  small 
drop  of  blood  is  only  about  one  five-millionth  of  the  whole  amount 
of  blood  in  an  average  body  1  think  it  will  be  plain  that  in  order 
to  make  the  diagnosis  of  malaria  easy  there  must  be  many  millions 
of  malaria   parasites  in   the  blood    of   the  person   under  examination. 

It  is  true  that  we  sometimes  find  specimens  of  blood  which  show 
an  average  of  one  parasite  per  field.  These  fortunately  are  rare,  for 
they  are  very  bad  cases.  You  can  easily  see  that  if  one  parasite  per 
field  means  16,000  parasites  per  cubic  millimeter  as  was  calculated 
above,  and  if  there  are  5,500,000  cubic  millimeters  of  blood  in  the 
body,  that  means  that  such  a  patient  was  carrying  in  his  blood 

16,000  times  5,500,000  or 

88,000,000,000  parasites. 

With  less  severe  infections  the  difficulty  of  proving  the  presence 
of  the  parasite   increases.      There  are  times  when   one  may  search  a 


( 


90 


FLORIDA  STATE  BOARD  OF   HEALTH 


BUREAU    OF    DIAGNOSTIC    LABORATORIES 

half  hour  or  more,   even   repeating   this  on   two   or   three   successive 
days   before   finding   the   parasite.        With     many    hundreds     of     such .  - 
specimens  coming  into  the  laboratories  it  will  be  seen  that  the  small- 
ness  of  our  force  imposes  a  limit  on  the  amount  of  time  that  can  be 
devoted  to  each  specimen. 

And  at  the  best,  a  negative  report  means  only  that  we  did  not 
find  the  thing  for  which  we  were  looking  and  not  at  all  that  it  was 
not  present. 


SUMMARY    OF  WORK— APRIL  1930 


Animal    Parasites    

Diphtheria  .„  „_ _ 

Typhoid   _.                     

Malaria                         

:k»onvil]e 

4295 
574 
328 
841 
18 
223 
429 

3496 

116 
153 
128 

Tampa 

136 

143 

6 

71 

181 

11  10 

49 

172 

198 

39 

Pcnsacola 

333 
15 
33 
33 

15 
36 

143 

143 

23 

Miami 

130 

124 

45 

II 

84 
1  12 
573 
135 
135 
414 
138 
489 

TalJfthassM 

128 

7 

41 

125 

33 
43 

1 

! 
22 
22 
33 

Total 

5765 
812 
583 

1153 

23 

Tuberculosis  „  „___„ 

426 
801 

Kahn  .           -._  .  ..  -  _ 

5179 

Wntrrr      Count  

185 

Water:      Colon  - - 

Milk:      Bacterial  Exam. 
Milk:      Chemical  Exam. 
Miscellaneous   .,.„ 

136 
867 
654 
712 

1060!      3075        774     2390       456   17296 


SPECIMEN  CONTAINERS  DISTRIBUTED    I  1430 


BIOLOGICAL  PRODUCTS  DISTRIBUTED 


Diphtheria   Antitoxin   ™ 10,000   units 

5.000   units 

Toxin  Antitoxin  — 

Schick  _ 

Tetanus   Antitoxin —   20,000   units 

1,500   units 

Typhoid  Vaccine  . 

Vaccine    Virus. 

Antirabic    Virus   s- 

Antimeningococcus  Serum  .\ 

Carbon  Tetrachloride  *. > 


62 

Packages 

22 

Packages 

7341 

c.  c. 

2700 

Tests 

6 

Packages 

965 

Packages 

1488 

Treatments 

3252 

Capillaries 

47 

Treatments 

8 

Cylinders 

3841 

Capsules 

FLORIDA  STATE  BOARD   OF  HEALTH 9| 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director. 

THE  TAX  OF  DISEASE 

Like  the  cost  of  government,  the  cost  of  sickness  must  be  paid. 
Graft  and  inefficiency  may  increase  the  cost  of  maintaining  law  and 
order  in  city  or  state  until  taxes  become  unbearable,  or  we  may  prac- 
tice economy  and  maintain  the  governmental  activities  with  a  reason- 
able   expenditure. 

Likewise,  in  matters  of  health,  because  of  indifference,  careless- 
ness or  inefficiency  on  the  part  of  the  health  department  or  the  peo- 
ple or  both,  the  cost  of  preventable  sickness  may  go  so  high  as  to  im- 
poverish whole  communities,   even   nations. 

Time  after  time  it  has  been  demonstrated  that  good  health  is 
purchasable.  Good  health  may  be  enjoyed  in  proportion  to  the 
amount  of  money  expended  wisely  in  the  prevention  of  disease.  Due 
to  great  differences  in  local  conditions  the  cost  of  maintaining  public 
health  varies  widely  in  different  communities. 

The  Handicap  of  Indifference 

Too  often  a  great  disaster  is  necessary  to  rouse  the  people  to 
action.  An  oft  repeated  story  in  the  history  of  public  health  is  that 
of  a  great  epidemic  which  awakens  people  and  impels  them  to  pro- 
vide sanitation,  vaccination  or  some  effective  means  of  preventing 
further  sickness  and  loss  of  life  from  some  communicable  disease  or 
other  health  hazard.  Right  here  in  Florida  the  value  and  effective- 
ness of  control  measures  have  been  demonstrated  repeatedly.  Now 
the  State  Board  of  Health  is  pointing  out  the  inevitable  cost  in  dol- 
lars and  human  lives  that  may  be  reduced  by  certain  inexpensive  and, 
reliable  preventive  measures.  The  only  thing  that  can  defeat  their 
purpose  is  INDIFFERENCE. 

Screening  Demonstration   for   Malaria  Control 

It  is  an  open  secret  that  malaria  has  been  taking  an  unusual  toll 
in  the  South.  Malaria  can  be  prevented.  Probably  the  most  ef- 
fective measure  is  to  exclude  mosquitoes  from  the  house.  Screening 
to  protect  the  family  is  well  adapted  for  the  individual  rural  home. 
This  can  be  done  at  a  cost  within  the  means  of  almost  anyone.  In 
the  counties  where  malaria  is  most  prevalent  the  State  Board  of 
Health  is  now  demonstrating  the  most  approved  methods  of  mosquito- 
proofing  the  rural  dwelling.  Those  who  have  attended  these  demon- 
strations have  expressed  their  wonder  at  the  simplicity,  cheapness  and 
ease  with  which  it  can  be  done.  Occupants  of  the  homes  used  for 
the  demonstrations  express  surprise  and  great  satisfaction  at  the  com- 
fort and  restful  sleep  which  they  enjoy  behind  good  screens  without 
the  necessity  of  keeping  up  a  "smudge"  all  night  long.  They  speak 
of  the  coolness  and  the  fresh  air,  since  they  no  longer  have  to  swelter 


1 


92 FLORIDA  STATU  BOARD   OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

behind  closed  shutters  to  keep  from  being  "eaten  alive."  They  say 
they  feel  more  like  plowing  and  planting  after  this  restful  and  refresh- 
ing sleep.  ONLY  ONE  THING  can  prevent  the  rest  of  us  from  en- 
joying the  same  protection,  that  is  INDIFFERENCE.  Those  who  miss 
the  demonstrations  or  postpone  action  will  be  the  losers. 

The   Hookworm    Assessment 

The  demonstration  does  not  stop  with  screening.  A  strictly 
sanitary  privy  is  being  built  in  each  of  the  twenty  counties  selected 
for  the  demonstration.  This  is  the  type  suited  for  the  rural  home. 
It  will  prevent  typhoid  fever,  bowel  complaint  among  children  and 
the  spread  of  intestinal  parasites  such  as  hookworms.  It  would  be 
poor  economy  to  spend  three  years  fattening  a  wormy  hog  if  you 
could  fatten  it  in  one  year  without  the  worms.  You  would  act  prompt- 
ly on  the  farm  expert's  advice,  give  the  hogs  some  worm  medicine, 
clean  up  the  pen  and  save  many  dollars  per  hog  in  feed.  Do  you 
think  a  wormy  boy  can  plow  corn  or  pass  to  the  next  grade  in  school 
as  readily  as  he  could  if  he  were  free  from  the  handicap?  Do  you 
think  the  wormy  girl  will  keep  house  as  well,  require  so  little  in  the 
way  of  cosmetics  or  marry  as  successfully  as  the  bright,  active,  rosy- 
cheeked  lass  who  has  been  protected  from  the  dangers  of  disease,  from 
retarded  mental  and  physical  growth,  from  anemia,  even  from  men- 
tal defectiveness  produced  by  hookworm  disease  and  malaria?  Isn't 
a  child  "worth  more  than  a  pig,  a  man  more  than  a  hog? 

If  you  did  not  attend  the  demonstration  in  your  county,  go  and 
visit  the  premises  and  make  careful  inspection.  You  will  be  cordially 
welcomed  by  these  new  friends  of  the  State  Board  of  Health.  You 
will   learn   something  worth  while. 

Every  case  of  malaria  and  every  person  with  hookworms,  every 
unscreened  house  and  every  insanitary  condition  in  your  community 
is  a  menace  to  you  and  your  famrly. 

Schedule  of  Demonstrations 

Washington   County — June   4th   and    oth, 
Jackson  County — June    1  1  th  and   I  3th. 
Holmes  County — June  1  8th  and  20th. 
Escambia  County — June  25th  and  27th. 
Suwannee  County — July  2nd  and  3rd. 
Alachua  County — July  9th  and   1  Ith. 

Watch  your  papers  for  further  announcements.  No  matter  what 
you  do,  what  your  circumstances,  whether  or  not  your  house  is 
screened  and  'sewered,  this  is  important  to  you.  The  prosperity  ot 
your  community  depends  on  the  health  of  all  of  the  people  Your 
interest  and  attendance,  the  knowledge  you  can  gain,  will  help  the 
cause. 


FLORIDA   STATE  BOARD   OF   HEALTH 93 

BUREAU    OF    ENGINEERING 
Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

NEW  SCHOOL  BUILDINGS 

If  your  school  district  is  to  vote  on  a  new  school  building  or 
has  voted  to  construct  one,  you  will  be  interested  in  a  regulation 
passed  by  the  State  Board  of  Health  early  in  .1930.  The  regulation 
is  now  in  effect  and  requires  submission  of  plans  of  school  buildings 
to  the  State  Board  of  Health  for  approval  before  contract  for  con- 
struction is  let.  The  State  Board  of  Health  does  not  go  into  the 
structural  safety  of  the  building  other  than  to  ascertain  if  all  doors 
open  outwardly  and  that  stairways  and  halls  are  ample  in  width.  For 
school  buildings  that  are  now  being  erected,  modern  sanitary  plumb- 
ing is  recommended.  This  means  that  first  the  school  must  have  a 
water  supply  that  is  taken  from  a  safe  source  and  handled  correctly. 
If  a  city  supply  is  available,  it  will,  of  course,  be  used.  If  there  is 
no  water  supply  nearby,  then  a  well  must  be  driven  or  drilled  and 
a  pump  jack  installed.  The  pump  may  be  gas  engine  or  electric 
motor  driven.  In  many  places  small  farm  unit  type  outfits  are  em- 
ployed taking  power  from  a  nearby  line.  Water  is  usually  pumped 
to  an  elevated  tank  or  a  pressure  tank  for  distribution  about  the 
school.  The  well  should  be  properly  cased  and  protected  against 
back  seepage.  It  should  join  the  pump  unit  in  an  all  metal,  water- 
tight union. 

A  word  here  might  be  of  value.  Many  Florida  waters  are  high 
in  hydrogen  sulphide  and  unless  this  is  aerated  out,  excessive  cor- 
rosion of  pipes  and  fixtures  may  tTke  place.  So,  before  water  supply 
well  is  accepted,  check  it  for  HZS  and  also  for  iron,  A  simple  iron 
test  can  be  made.  Collect  a  sample  in  a  quart  mason  jar,  shake  it 
thoroughly  and  allow  it  to  stand  for  a  few  days  in  the  light.  If  iron 
is  present  in  an  appreciable  amount,  it  will  easily  be  noticed. 

Piping  should  be  of  large  enough  size  to  give  the  pressure  and 
volume  necessary  to  operate  the  fixtures.  This  is  important  if  flush 
valve  operated  toilets  are  to  be  installed.  Enough  water  should  be 
available  to  flush  all  the  toilets,  one  right  after  another.  Durable 
piping  such  as  heavy  galvanized  piping  or  copper  should  be  used. 
Care  should  be  taken  to  have  enough  valves,  mains,  etc.,  inserted  so 
that  repairs  can  be  made  without  cutting  off  the  entire  school. 

Toilet  fixtures  should  be  of  the  standard  flush  type.  Cheap 
fixtures  will  not  be  permitted  as  they  do  not  give  service.  Seats  must 
be  of  the  half  round  or  horse-shoe  type.  For  the  girls,  a  minimum 
of  two  stools  must  be  provided  and  extra  stools  at  the  rate  of  one 
for  every  IS  pupils;  for  the  boys,  a  minimum  of  2.  or  one  for  every 
20  boys,  with  a  vertical  type  urinal  of  one  stall  for  every  30  boys. 
Hand  basins  shall  be  provided  at  least  one  in  each  toilet  room  for 
every  50  pupils  served.  Cold  water  only  need  be  provided.  Liquid 
soap  and  paper  towels  shall  be  provided  in  each  toilet  room.      If  the 


94  FLORIDA  STATE  BOARD   OF   fj^LTH 

BUREAU   OF    ENGINEERING 

school  is  to  feature  athletics,  then  showers  should  be  provided,  at 
least  four  in  number  for  the  use  of  the  contestants.  Partitions  between 
fixtures  are  not  required  but  the  door  opening  into  the  toilet  rooms 
shall   open  inwardly  and  be   properly  screened. 

All  toilet  rooms  shall  have  at  least  one  large  window  opening  to 
the  outside  and  preferably  two.  Additional  fixed  glass  openings  may 
be  provided  for  lighting  purposes.  Alt  toilet  rooms  shall  have  artifi- 
cial light  units  controlled  from  a  wall  switch  near  the  door  if  the 
building  is  electrically  illuminated.  The  floors  shall  be  of  concrete 
or  other  impervious  material  (not  wood)  property  constructed  to 
drain  to  a  central  floor  drain.  Side  walls  shall  be  of  impervious 
material  at  least  six  inches  above  the  floor  so  that  the  room  can  be 
easily  scrubbed  or  flushed  out.  If  the  structure  is  heated,  a  heating 
unit  shall  be  placed  in  each  toilet  room. 

Wood  work  and  walls  shall  be  painted  with  a  light  colored,  wash- 
able paint.      Glass  used  in   toilet   room  windows  shall   be   translucent. 

All  drinking  fountains  (a  minimum  of  2  per  school  of  4  rooms 
is  required)  shall  be  of  the  slanting  jet  protected  nozzle  type.  They 
may  be  of  the  wall  or  pedestal  type  but  shall  be  of  the  hand  or  foot 
operated  valve  type.  Each  fountain  shall  be  so  adjusted  that  when 
the  valve  is  wide  open  the  jet  falls  within  the  bowl  of  the  fountain. 
Straight  up  bubblers  will  not  be  approved. 

Sewage  disposal  shall  be  by  connection  to  a  sanitary  sewer,  if 
available,  or  through  septic  tanks  of  approved  design  and  construc- 
tion, properly  located.  The  State  Board  of  Health  will  gladly  go 
over  the  project  on  the  site  and  indicate  to  the  designing  architect 
the  site  for  the  septic  tank.  It  is  better  to  run  a  long  line  to  connect 
to  a  sewer  line  than  to  build  a  tank  so  care  should  be  taken  in  adopt- 
ing a  method  of  disposal.  The  State  Board  of  Health  furnishes  model 
designs  of  septic  tanks  built  in  place. 

The  foregoing  is  given  only  as  indications  of  what  will  be  checked 
on  the  plans  and  what  will  be  expected  on  the  plans  and  specifications. 
The  regulation  is: 

RULE  NO.    101 

In  accord  with  provisions  of  Chapter  6836  and  7822  Acts  of 
1915,  Laws  of  Florida,  the  following  regulations  governing  the  Sani- 
tation of  School  Buildings  in  the  State  of  Florida  have  been  adopted 
by  the  State  Board  of  Health. 

Section  1.  All  School  building  whether  public  or  private  in 
the  State  of  Florida  having  four  or  more  class  rooms  or  accomodat- 
ing more  than  125  pupils  shall  be  provided  with  adequate  water 
supplies  and  sanitary  facilities  as  hereinafter  prescribed. 

Section    2.      Such   schools    shall   be   provided   with   an    adequate 


FLORIDA  STATE   BOARD   OF  HEALTH 95 

BUREAU    OF   ENGINEERING 

supply  of  potable  water  under  satisfactory  pressure.  Where  munici- 
pal water  supplies  or  deep  free  flowing  wells  are  available,  same  shall 
be  used.  In  the  absence  of  such  supplies,  the  schools  shall  be  provided 
with  necessary  equipment,  satisfactorily  installed  and  operated  to 
furnish  at  all  times  such  school  is  in  session  an  adequate  supply  of 
potable  water. 

Section  3.  Such  schools  shall  provide  fixtures  for  the  distribu- 
tion of  water  of  such  design  and  construction  as  to  prevent  contami- 
nation. 

Section  4.  Such  schools  shall  be  provided  with  an  adequate 
number  of  flush  type  toilets,  urinals  and  lavatories  of  satisfactory 
design  and  construction  properly  installed  and  connected  to  the  city 
sewer  system  or  to  a  sewage  treatment  tank  of  design  and  construc- 
tion approved  by  the  State   Board  of  Health. 

Section  5.  Any  county  school  board,  district  trustee  or  any 
person,  firm  or  corporation  contemplating  the  construction  of  a 
building  for  school  purposes  in  this  state  shall  submit,  before  contract 
for  construction  is  let,  the  plans  and  specifications  of  such  building 
to  the  State  Board  of  Health  showing  clearly  all  details  of  the  water 
supply  system  including  source  of  supply  and  also  all  details  of  the 
sanitary  facilities,  sewerage  system  and  sewage  disposal,  for  the  ap- 
proval of  said  Board  and  no  contract  shall  be  let  until  such  approval 
in  writing  is  obtained  by  the  school  authorities. 

Section  6.  '  That  any  public  or  private  school  now  in  operation 
in  this  state  not  conforming  to  any  section  of  this  regulation  shall 
after  due  notice  be  given  one  year  from  the  date  of  such  notice  to 
comply  with  the  provisions  of  this  rule. 

Section  7.  Any  county  school  board,  school  trustee  or  any  per- 
son, firm  or  corporation  conducting  any  public  or  private  school  in 
this  state  who  shall  after  being  given  due  notice  in  writing,  fail  to 
comply  with  any  sections  of  this  rule  shall  be  guilty  of  a  misdemeanor 
and  upon  conviction  thereof  shall  be  punished  as  prescribed  by  law. 

Section  8.  Any  public  or  private  school  in  this  state  found  to 
be  in  an  insanitary  condition  or  a  menace  to  the  health  of  the  pupils 
may  be  ordered  closed  by  a  duly  authorized  officer  of  the  State 
Board  of  Health  after  a  thorough  inspection,  and  any  school  so 
ordered  closed  shall  not  be  reopened  for  school  purposes  until  the 
conditions  at  fault  are  remedied. 

Section  9.  In  case  any  section  or  sections  of  this  rule  are  de- 
clared unconstitutional  the  same  shall  not  invalidate  any  other  sec- 
tion therein  contained. 

Section   10.      This  rule  shall  become  effective  March   1,    1930. 


96 


FLORIDA  STATE   BOARD   OF   HEALTH 


BUREAU    OF    VITAL    STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

BIRTHS — 1929 

Everyone  is  interested  in  the  census  taking  which 
means  the  counting  of  every  human  being  in  the 
United  States.  According  to  the  records  just 
compiled,  the  natural  increase  in  Florida,  which 
is  the  excess  of  births  over  deaths,  indicates  that 
wc  have  8,698  more  persons,  on  this  basis.  The  ex- 
cess of  births  over  deaths  among  the  white  popula- 
tion was  7,436  and  the  natural  increase  of  the  col- 
ored, shown  by  the  excess  of  births  over  deaths,  was   1,262. 

During  the  calendai  year  1929,  a  total  of  26,853  births  was 
put  on  file  with  the  State  Board  of  Health;  18,296  white  and  8.557 
colored.  The  number  of  births  occurring  has  shown  a  decrease  in 
fifty  counties  while  an  increase  is  shown  in  the  number  of  births  re- 
ported in  1929  over  the  year  1928  in  the  following  seventeen 
counties:  Baker,  Bradford.  Citrus,  Collier,  Dixie.  Flagler.  Gilchrist, 
Gulf,  Hendry,  Hernando,  Liberty,  Martin,  Okeechobee,  Seminole, 
Taylor,  Walton  and  Washington.  This  decrease  in  the  number  of 
births  registered  is  not  affected  by  failure  to  report.  The  five  hun- 
dred registration  districts  in  Florida  are  more  efficiently  operated 
at  present  than  at  any  other  time  in  the  history  of  the  state.  Local 
registrars,  in  many  cases,  have  been  in  office  as  long  as  twelve  years 
and  have  become  very  efficient  in  their  efforts  to  secure  cooperation 
from  physicians  and  others  who  are  required  to  make  reports.  Phy- 
sicians, as  a  class,  are  reporting  much  more  promptly  than  in  previous 
years.  Midwives,  who  are  now  very  carefully  supervised  by  the 
nursing  staff  of  the  State  Board  of  Health,  are  also  required  to  report 
promptly. 


METHODS    OF    REMOVING    HAIR 

Measures  for  removing  excess  hair  are  discussed  in  the  current 
Hygeia  by  Dr.  Herman  Goodman,  a  skin  specialist  well  qualified  to 
judge  the  efficacy  of  such   procedures. 

Many  liquids  and  waxes  are  advertised  as  capable  of  removing 
hair  permanently.  There  is  no  reason  for  optimism  on  this  subject, 
for  the  hair  does   grow   again,    Dr.    Goodman   says. 

Chemical  depilatories  are  popular,  but  it  should  be  remembered 
that  the  horny  substance  of  the  hair  and  skin  are  of  the  same  com- 
position. Whatever  acts  on  the  hair  acts  on  the  skin  as  well.  Inflam- 
mations are  likely  to  occur  unless  proper  care  is  taken  to  remove  the 
depilatory  quickly  and  to  cover  the  skin  with  ointment  or  oil.  The 
only  safe  method  is  the  use  of  the  electric  needle  in  the  hands  of  a 
competent  operator. 


FLORIDA  STATE  BOARD   OF  HEALTH 


97 


BUREAU    OF    VITAL    STATISTICS 

The  following  tables  indicate  the  number  of  deaths  from  certain 
diseases  by  months,  for  1930  as  compared  with  the  previous  year. 
{ Provisional    figures. ) 

TYPHOID    DEATHS 


Y>ar 

Ian. 

icb 

Tola! 

Mar.     Apr.     May  June    July    Aug.    Sept. 

Oct. 

Nov, 

Dec. 

Total 

1930 

1929 

10 
2 

4 
4 

14 

6 

6     11       8     11     13       7      4 

6 

5 

6 

83 

^t 

J«n 

MALARIA    DEATHS 

Feb.   Total   Mar.      Apr-     May   June     July    Aug.     Sept. 

Oct. 

N.iv. 

Dec.  Tola! 

1930 
1929 

12 
24 

12 
7 

24! 

31 J    15     14    30    40    65     59    72 

71 

40 

33 

470 

Year 

Jan. 

DIPHTHERIA   DEATHS 

Feb.   Total   M«r.      Apr.     May   Juno    July    Auk.     Sept. 

Oct. 

Nov, 

Dec.  Total 

1930 
1929 

5 

S 

5|    I0J 

6j    141     3       3       3       1       1       8     10 

6 

6 

12 

67 

Y«r 

Jan- 

TUBERCULOSIS    DEATHS 

Feb.   Total    Mar*      Apr,     May  June     July    Aug.     Sept, 

Oct. 

V>v 

Dec.   Total 

1930 

1929 

85 
81 

76,161 

109  190 

88    85    81    76   88    82    71 

80 

87 

86  1014 

DANGER    IN   AMERICAN   LIFE 

Danger  of  crushing  personality  is  the  most  serious  difficulty  in 
American  life  today,  says  Dr,  Ray  Lyman  Wilbur,  Secretary  of  the 
Interior,   in  an  article  in   the  May  issue  of  Hygeia, 

We  are  in  danger  of  becoming  mere  menagerie  animals,  caged, 
captured  by  ourselves.  We  live  in  shells  made  of  steel,  concrete, 
pavement,  wires,  artificial  ventilation,  artificial  lighting.  We  drive 
out  of  this  environment  the  trees,  the  flowers,  the  birds,  the  grass, 
the  open  spaces,  the  things  that  have  always  made  life  and  happiness 
for  the  human  being. 

And  if  we  make  ourselves  menagerie  animals,  the  Secretary  con- 
tinues, what  then?  The  menagerie  animal  doesn't  breed  well;  it 
doesn't  have  vigor;  it  has  too  much  leisure;  it  loafs;  it  wastes  time; 
it  gets  fat;  it  is  of  no  use  in  the  long  run  in  its  biologic  processes. 
That  is  the  thing  we  face,  he  declares. 

We  must  struggle  all  the  time  to  uphold  the  dignity  of  the  human 
r>eing  as  such.  Dr.  Wilbur  concludes.  We  must  seek  training  adapted 
to  the  individual  for  the  development  of  personality.  We  have  to 
*hink  in  terms  of  selection,  of  segregation,  if  you  please,  of  human 
lualities,  or  we  may  lose  everything  in  the  mass. 


98 


FLORIDA   STATE   BOARD   OF   HEALTH 


BUREAU   OF    VITAL   STATISTICS 

Total  Births,   (exclusive  of  Stillbirths)  by  Color  and  by  Counties,   1929 


BIRTHS 


COUNTIES 


Total 

White 

Colored 

0. 

State „„ 

26.853 

18,296 

8.557 

I. 

Alac  h ua 

653 

325 

328 

2. 

Baker 

166 

124 

42 

3. 

Ray 

264 

192 

72 

4. 

Brad  ford 

177 

134 

43 

5. 

Brevard ...... 

200 

137 

63 

6. 

Broward 

367 

201 

166 

7. 

Calhoun , 

187 

156 

31 

55. 

Charlotte  

60 

50 

10 

8. 

Citrus 

106 

59 

47 

9. 

Clay . 

102 

79 

23 

62. 

Collier -. 

27 

23 

4 

10. 

Columbia 

304 

180 

124 

11. 

Dade 

2,225 

1.557 

668 

12, 

DeSoto ~ 

185 

112 

2.945 

153 

80 

1,924 

32 

56 

Durie - 

32 

n. 

Duval 

1,021 

14. 

Escambia „_ 

1,083 

863 

220 

53 

Flagler _ 

45 

21 

24 

15. 

Franklin _  ... 

136 
689 

88 
272 

48 

16. 

Gadsden* 

417 

64. 

Gilchrist 

109 

103 

6 

57 

Glades 

50 

33 

17 

65. 

Gulf 

74 

52 

22 

17 

Hamilton ~ 

183 

94 

89 

56 

204 

191 

1  3 

63 

Hendry 

66 

65 

1 

44 

48 

455 

18, 

Hernando — 

108 

64 

59 

Highlands 

197 

149 

19. 

Hillsboro..., 

2,626 

2,171 

?0 

Holmes „ 

248 

245 

3 

50 

310 

273 

5 
120 

66. 
21. 
22. 
23. 
24. 

Indian   River..... 

Jackson 

Jefferson t 

Lafayette 

Lake.":- 

145 
740 
343 
54 
394 

95 

430 

70 

49 

274 

♦State  Hospital  Inmates  Included. 


FLORIDA  STATE  BOARD   OF   HEALTH 


99 


BUREAU    OF    VITAL   STATISTICS 

Total  Births,    (exclusive  of  Stillbirths)  by  Color  and  by  Counties,   1929 

(Continued) 


r     COUNTIES 


BIRTHS 


Total 

White 

Colored 

25. 

Lee 

266 

208 

58 

26. 

Leon 

490 

172 

318 

27. 

Levy. 

234 

139 

95 

m 

Liberty 

121 

77 

44 

29. 

Madison „ 

382 

150 

232 

30. 

Manatee ... 

363 

224 

139 

31. 

Marion 

493 

253 

240 

67. 

Martin 

90 

59 

31 

32. 

Monroe... 

255 

197 

58 

33. 

Nassau 

172 

100 

72 

34.- 

Okaloosa 

198 

179 

19 

54. 

Okeechobee 

72 

53 

19 

35. 

Orange. 

927 

686 

241 

36. 

Osceola 

139 

99 

4a 

37. 

Palm   Beach 

/    750 

(      186 

868 

1.427 

522 

228 

3fi 

Pasco 

155 

637 

1 . 1 09 

31 

39 

Pinellas 

23J 

40. 

Polk _ 

318 

41. 

Putnam 

346 

180 

166 

42. 

St.  Johns 

313 

213 

100 

43 

St.   Lucie 

130 

86 

44 

44. 

Santa    Rosa 

282 

246 

36 

60, 

Sarasota 

208 

165 

43 

45. 

Seminole 

443 

220 

223 

46. 

Sumter 

178 

108 

70 

47, 

297 

172 

125 

48, 

Taylor 

164 
129 
644 

107 

95 

468 

57 

61, 

Union. 

34 

49. 

Volusia 

176 

50. 

Wakulla 

97 

57 

40 

51 

Walton 

324 

255 

69 

52. 

Washington 

291 

202 

89 

"We  stop  playing,    not  because  we  grow  old;  we  grow  old  be- 

fiuse  we  stop  playing." 

— Herbert  Spencer. 


100 


HUMAN  LIFT!  IS  THE  STATERS  GREATEST  ASSET 


r 


e»— a. 


_Jbr 

-ttte 


PRIZEWINNERS, 


MOUE.  CONTEST 
Jor 

HEALTH 
LIMERICK<5 

ANDPOEMtf 


£<S& 


-=ss?sr^A 


Eat  a  little,  chew  d  lot. 

Drink  plenty  d  water  cold  or  hot. 

Take  many  walks. 

And  mu.cn  sleep. 
This  kind  of  living  helpj  a  heap 


—     MARGARET    FALUN 

9    YEAftl    QU> 


C3 


€2 


There  was  a  boy.  oh  so  thin 
He  never  had  yiQpr  and  vim. 

When  good  food  he  ate. 

He  sained  normal  -weight. 
And  since  then  real  healthy  he's  been 


—   HELEN   HARRIS 
IS  fEARiOLO 


04  to 


there 


jotssAA 


'*°  «■££*« 


\tvia* 


to**" 


*****?» 


£****? 


<SSb 


W->« 


There  is  a  boy,  Jim  Fox. 
Who  could  not  wrestle  or  box. 
So  the  doctor  advises, 
"Tdke  more  exerci&es,* 
' And  now  hei  as  strong  asan  ox 


MORE  PRIZE-WINNING  POEMc? 
will  appear  in  a  later  issue  of  the  Bullet* 


a 


WILLI*   HA^UFM 

W  YEAftl  OLD 


This  Issue  Exceeds  1 1,000  Copies 


ptORID^ 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED  JULY,    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  as  Second   Class   Matter,  October  27,   1921 
■I  the   PostoffEce  at   Jacksonville,    Florida.  Under  the  Act  of  August   24,    1912 

Thia  Bulletin  will  be  sent  to  any  address  in  the  State  free  of  charge. 

Vol.  22  JULY,    1930  No.  7 


Edited   by 
STEWART  G.  THOMPSON,  D.P.H.,  M«nb=r 

American    Medical    Editors*  and   Authors'   Assn. 


SPECIAL  ARTICLES 

MEASLES— Brin  k 

EXAMINATION  OF  MILK— Eaton 

A  HEALTHIER  FLORIDA— Thompson 

WATER  PURIFICATION  PLANTS— Filby 

"'  MATERNAL  MORTALITY  SURVEY— Bktckly 

STATE-WIDE     HEALTH     CONFERENCE— Hanson 


HENRY  HANSON,  M.  D„  STATE  HEALTH  OFFICER 


102 


FLORIDA   STATE   BOARD   OF   HEALTH 


Chu.    H.    Mnon.    Pres. 
Jacksonville 


BOARD   MEMBERS 

H.    Mason    Smith,    M. 
Tampa 


Win.   D.   Nobles.   M.  D. 
Penaacola 


STATE  HEALTH  OFFICER 

Henry    Hanson.    M-    Da 


BUREAUS  AT  JACKSONVILLE 


Diagnostic   Leboratories- 
*  Vital    Statistics. 


Communicable    Diimci- 
Eztgiiiae  ring- 


Child  Hygleos   and   Public  Health   Nursing. 


AccodoUb 


(fhildre 


Crippled 

550   Local  Ragle  trars    (County   Hat   furniahad   on   rsquca 

h . ,.— — « — — Anna  C 


DIRECTORS 

Paul  Eaton,  M.  D„  D.   P.  H. 
Stewart   C-   Thompaon.   D.   P.    H. 
F.  A.  Brink.  M.  D, 
Ellsworth  L.   Fllby.  C  .E. 
Lucils   Spire    Blachly.    M.    D. 
Screven   Dollar 
F.   L.   Fort.   M.   D. 


'Registration    Inspector 
Drug  Store   Inspector 


Emmons 
H.  R.   Monroe 


~> 


Jacksonville- 
Miami - 


Peniacol* 


Tallahassee- 
Tarn  pa 


LABORATORIES 


Pearl    Griffith.    B.    E. 
E.    R.    Powell 
Jane    B.    Currie,    B.   S. 
Elizabeth    Bvrd.    B.    3 
H.    D.    Venters.    B.   S 


MEDICAL  OFFICERS 


DeFuniak    Springe 

Jacksonville 

Vero     Beach 

Tailaha  ai  ee — — 

Ta  mna . — 


C.  W.    McDonald.    M. 

B.  C.    Wilson,   M.   U 

W  A.    CI. Hon.    M.     D 

A.  P.    Ilamsnn.    M.    D 

A  C.   Haniblin.   M.   D. 


DISTRICT   SANITARY    OFFICERS 


limps 

Jacksonville 

Miami 


Oca  la- 


Orlando 


Pun  la  Cor  da 
Tails  ha  as  ee_ 
Tampa 


__  *V.    B.    Lamouraua.    C.    E, 

—  Fred  A.   Safer 

—  Geor*r    B     Heed 
C.  A.   Muliu**«\ 

....     Russell   Broughntan 
* —    G.    A.    Rennay 
_   C.  N.   Hobbs 

—  D.   H.  Osburn 
'Assistant    Engineer 


Lake   City. 

Tampa 

Arcadia 


PUBLIC   HEALTH   NURSES 


DaFuniak    Springe 

Eden,   R,    F.    D.    Jensen 
Lake   City 

Madison— — . — . — . 

Rusk  in 


Starke- 


-Clio    McLaughlin.    K     N 
'Harriet    I.   Sherman.    H     N. 

.,   Juic   Graves,   R.   N. 

_.  Nanna   Colby,    R,    N. 

...   Sarah   Ida    Richards,   R.    N. 

-  France*  Hall.  R.   N 

_  Thora    Roberts.    R.    N. 

-  Joyce   Ely.   R.   N. 
Mary   G.   Dodd.   R.   N 

*  Field    Supervisor 


Jacksonville- . 


COUNTY  HEALTH  UNITS 

..__ T.  C.   Stoy    IU.  S.    P.   H.    S.l 


/ 


_         FLORIDA  STATE  BOARD   OF   HEALTH 10? 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

STATE-WIDE  HEALTH  CONFERENCE 

On  June  1  2  th,  Governor  Doyle  E.  Carlton  presented  one  of  the 
most  important  and  vital  problems. in  the  future  development  of  Flor- 
ida when  he  convened  a  state-wide  health  conference  at  the  Capitol. 
The  purpose  of  the  meeting  was  to  inform  the  people  of  Florida  as  to 
the  importance  of  securing  a  full  time  health  service  in  every  county 
within  the  state  to  the  end  that  the  enormous  economic  losses  now 
sustained  by  reason  of  preventable  diseases  could  be  curtailed.  To 
this  meeting  were  invited  the  Governor's  Cabinet,  the  State  Board  of 
Health  and  Directors  of  Bureaus,  President  and  Executive  Committee 
of  the  Florida  Medical  Association,  President  of  the  University  of 
Florida  and  the  Health  Council,  Regent  of  the  D.  A.  R.,  President  of 
the  Federated  Women's  Clubs,  President  of  the  Parent-Teachers*  Asso- 
ciation, President  of  the  State  Chamber  of  Commerce,  State  Comman- 
der of  the  American  Legion,  State  Governor  of  Rotary  Club,  State 
Governor  of  Kiwanis  Club,  State  President  of  U.  D.  G,  State  President 
of  Exchange  Club,  State  President  of  Civitan  Club,  State  President  of 
Lions  Club,  State  Commissioner  of  Welfare,  President  Florida  State 
College  for  Women,  President  State  Bankers'  Association,  President 
State  Bar  Association,  President  State  Business  Women's  Club,  Pres- 
ident League  of  Municipalities,  President  Florida  Public  Health  Asso- 
ciation, President  Anti-Mosquito  Association,  President  State  Press 
Association,  President  Florida  A.  and  M.  College  and  other  promi- 
nent citizens. 

The  Governor  presided  at  the  meeting  and  in  his  address  stressed 
the  fact  that  the  health  of  the  people  of  Florida  is  their  greatest  asset, 
that  he  was  intensely  interested  in  making  Florida  the  healthiest 
state  in  the  Union  and  that  this  is  one  of  the  main  objectives  of  his  ad- 
ministration. 

Dr,  Julius  C.  Davis,  President  of  the  State  Medical  Association, 
spoke  on  the  importance  of  the  physicians  of  Florida  realizing  their 
individual  ai\d  collective  responsibility  and  obligations  in  the  matter 
of  promoting  public  health  and  stated:  "In  Florida,  famous  for  its  ex- 
position of  the  superlative  and  modern  civilization,  we  should  be  rid 
of  the  waste  and  inefficiency  due  to  disease."  He  further  detailed 
the  loss  in  the  value  of  lives  from  malaria  last  year  as  being  $2,350, 
000  to  the  state,  a  tremendous  sum  to  pay  for  the  privilege  of  hav- 
ing one  disease. 

Mr.  Phil  S.  Taylor,  representing  Mr.  Mayo.  Commissioner  of 
Agriculture,  made  a  talk  on  "The  Farmers"  Need  in  the  Conservation 
>f  Rural  Health." 

Dr.  J.  J.  Tigert,  President  of  the  Florida  Health  Council,  stressed 
"»  his  remarks  the  importance  of  health  to  education  and  brought  out 


104 FLORIDA  STATE   BOARD   OF  HEALTH 

ADMINISTRATION 

the  importance  of  having  full  time  health  service  in  the  schools  of  the 
state. 

Dr.  N.  A.  Upchurch,  representing  the  Florida  League  of  Munci- 
palities,  endorsed  the  movement  to  establish  a  full  time  health  service 
in  every  county  of  the  state  and  pledged  the  Leagues  cooperation. 

Dr.  Gerry  R.  Holden,  of  the  Executive  Committee  of  the  Florida 
Medical  Association,  stated  that  the  Committee  ■was  behind  the  move- 
ment and  approved  it  fully. 

Hon.  W.  S.  Cawthon,  State  Superintendent  of  Public  Instruction, 
stressed  the  needs  of  better  health  conditions  throughout  the  state 
especially  within  the  school  and  pre-school  population  and  pledged  the 
cooperation    of   his    department    to    the    fullest  extent. 

Dr.  T.  Z.  Cason.  speaking  for  the  Florida  Public  Health  Asso- 
ciation, emphasized  that  only  by  community  health  work  would  real 
progress  be  made  against  tuberculosis. 

Dr.  J.  R.  E.  Lee,  President  Florida  A.  &  M.  College,  stressed 
the  importance  of  consideration  of  the  close  relationship  of  health  be- 
tween the  white  and  colored  population  and  brought  out  the  fact  that 
disease  knows  no  distinction  of  color  or  race  and  that  we  must  elimi- 
nate it  from  both  races  to  have  a  healthful  state. 

Projected  Rural  Health  Program 

The  writer  then  explained  in  detail  the  program  which  the  State 
Board  of  Health  desires  to  make  effective  as  follows: 

The  State  Board  of  Health  after  due  consideration  and  study  of 
the  prevalence  of  preventable  diseases  throughout  the  state,  especially 
in  the  rural  sections,  is  convinced  of  the  need  of  a  full  time  health 
service  in  every  community.  The  following  plan  for  a  full  time  health 
service  will  give  the  entire  citizenship  pi  our  state  a  more  effective 
disease  control  under  modern  public  health  administration  and  prac- 
tices and  will  have  as  its  objective  the  curtailment  of  unnecessary  sick- 
ness and  suffering  and  a  saving  of  the  enormous  monetary  losses  now 
sustained  annually  throughout  the  state  by  reason  of  the  prevalence 
of  illness. 

1.  Objective: —  A  full  time  health  service  for  the  citizens  of  every 
county  in  the  state  to  the  end  that  preventable  diseases  may  be 
more  effectively  controlled  in  Florida. 

2.  Budget: —  A  minimum  budget  of  $10,000  for  a  population 
unit  of  1  5,000  or  more  with  an  assessed  valuation  of  not  less  than 
$6,000,000  to  provide  for  the  minimum  unit.  This- budget  to 
be  based  J/2  to  M  or  me  amount  being  provided  by  the  county, 
or  counties  if  combined,  and  Yj  to  J/j?  by  the  State  Board  of 
Health. 


FLORIDA   STATE  BOARD   OF  HEALTH 105 

ADMINISTRATION 

Personnel: The  personnel  of  the  minimum  unit  for  a  county 

or  for  two  or  more  counties  combined  into  a  district  shall  consist 
of  one  medical  director,  one  public  health  nurse,  one  sanitary 
officer  and  one  office  clerk,  all  personnel  to  be  trained  in  public 
health  administration  and  practice  before  appointment.  The 
director  of  the  unit  is  to  be  appointed  by  the  County  Commis- 
sioners upon  recommendation  and  with  the  approval  of  the  State 
Health  Officer. 

Activities: —  All  full  time  health  units  shall  conduct  a  well 
rounded  scientific  program  of  education  of  the  cause,  methods 
of  transmission  and  prevention  of  preventable  diseases  prevalent 
within  the  community  served,  and  demonstrate  practical  appli- 
cation of  scientific  methods  of  control.  The  following  are  some 
of  the  important  activities  that  should  be  conducted  by  the  unit. 

1 .  Control  of  all  contagious  and  infectious  diseases,  inclu- 
ding necessary  isolation,  immunization  and  supervision  of  con- 
tacts and  education  of  the  public  relative  to  the  disease  present. 

2.  Medical  inspection  of  all  school  and  pre-school  chil- 
dren to  be  conducted  systematically,  supplemented  by  a  proper 
nursing  program  which  should  have  as  its  objective  to  secure  cor- 
rection of  remediable  defects  and  personal   hygiene  education. 

3.  (a)      Tuberculosis  control   with   early      finding      clinics, 
prompt   follow-up    of   the    suspicious  cases  and    getting   them    in 
the  hands  of  their  family  physician  at  earliest  moment  for  treat- 
ment,   (b)   The  open  case  often  hopelessly  beyond  possibility  of 

cure  should  be  isolated. 

4.  Inoculation  and  immunization  of  the  entire  population 
according  to  age  groups  and  necessity  thereof  against  typhoid 
fever,   diphtheria,   smallpox,  etc. 

5.  Sanitation  of  premises,  which  should  include  an  ap- 
proved method  of  excreta  disposal,  a  safe  water  supply  and  pro- 
tection against  flies  and  mosquitoes. 

6.  Child  hygiene  to  be  worked  out  to  meet  the  local  con- 
ditions and  carried  on  both  by  the  director  and  nurse. 

7.  Venereal  disease  program  with  clinics  and  treatment 
facilities  ■when  recommended  by  the  local  medical  society  and  to 
be  undertaken  when  conditions  warrant. 

The  program  of  activities  of  each  unit  will  be  presented  to  the 
focal  medical  society  for  approval.  Changes,  when  necessary  to 
n^et  local  conditions,  will  be  recommended  by  State  Board  of  Health. 
• "  make  possible  the  projection  of  a  full  time  health  service  for  every 
c'  nmunity  the  following  objectives  will  be  necessary,  and  active  co- 
operation bf  all  citizen  groups  will  materially  assist  the  State  Board 
ot  Health  in  the  development  of  the  program. 


106  FLORIDA   STATE   BOARD   OF   HEALTH 


ADMINISTRATION 

1 .  An   enabling  act,   to  enable  county  and  city  commissioners 

to  make  appropriation  for  full  time  health  service  as  a  part 
of  their  local  government. 

2.  State   financial  assistance  to  counties  to  stimulate   their  in 
terest  in  protection  of  the  health  of  the  citizenship. 

A  communication   from   Mr.   Chas.   H.   Mann,   President  of  the 
State  Board   of  Health,    read   by  Mr.    B.    A.    Megirmiss,    representing 
Kiwanis   Club,    indicated    strongly   the    desire    of   the    State    Board    of 
Health  to  make  Florida  the  healthiest  playground  of  the  world.      Mr 
Mann  stated   in   part:      "Only  a   few  years  ago   many   diseases  were 
looked  upon  with  dread  as  they  swept  communities  and  nations,  tak- 
ing a  staggering  toll  of  human  life.  Today  smallpox,  and  yellow  fever, 
the  effects  of  which  we  have  experienced   in  our  own  state  in   years 
past,  have  been  practically  banished  from  civilization.  *  *  *  Typhoid, 
deadly  in  character  only  a  few  years  ago,  can  be  prevented  through  in- 
oculation and  modern  sanitary  measures.  *  *  *  Diphtheria  has  taken 
the  lives  of  untold  thousands  of  children  in  the  past  but  is  no  longer 
looked   upon  with   the  same  degree  of  terror.      Science  has   found  a 
way  to  annihilate  its  potency  through  serums.   *   *  *  Malaria  in   our 
state,  however,  is  on  the  increase  and  a  further  increase  may  be  ex- 
pected  if  immediate  steps  are  not  taken  to  combat  energetically  its 
ravages  through  sanitation  and  control  measures.  *  *  *  Hookworm  is 
one   of  our   most  widespread    diseases.      It   lowers   the   resistance  to 
other  infection  and  destroys  the  economic  power  to  earn  a  livelihood. 
*  *  *  Florida  has  its  full  share  of  this  malady.     This  can  be  success- 
fully combated  through  medical  and  sanitary  measures.  *  *  *  Florida, 
the  playground  of  the  nation,  should  be   vitally  interested  in  all  matters 
pertaining   to   health.      Thousands  of  visitors  enter  our  state   yearly, 
some  to  enjoy  our  balmy  climate,  others  to  make  their  homes.     The 
revenue  to  the  state  is  enormous  and  the  influx  of  tourists  and  home 
seekers  will  increase  provided  health  conditions  can  be  maintained  at 
a   high  standard.      Every  county  in  our  state  that  expects  to   benefit 
from  tourists  and  increasing  population,  must  have  its  house  in  order, 
"and  no  better  method  can  be  inaugurated   than   to   establish   its  own 
County  Health  unit  for  the  service  of  its  citizens,   in     order  that  the 
health  of  the  county  may  be  conserved.     If  every  county  in  the  state 
'would   make  health   protection   an  important   part   of  county  govern- 
ment, it  would  produce  results  far  in  excess  of  its  fondest  hopes,  would 
pay  big  dividends  and  make  Florida  one  of  the  greatest  states  in  which 
to-  live,  and   attract  thousands  of  people  and   millions  of  dollars.      It 
is  estimated  that  sickness  in  Florida  at  the  present  time  costs  its  citi- 
zens $1  5,000,00t).00  per  annum.     These  figures  are  considered  con- 
servative by  competent  authorities.  *  *  *  Your  State  Board  of  Health 
will  assist  you  in  every  way  possible  to  make  your  community  immune 
to  disease.     Health  is  Florida's  greatest  asset  and  every  citizen  should 
feel  it  incumbent  upon  him  to     do  his  part  in  assisting  in  the  carrying 
on  of  every  health  program  that  may  be  prescribed.  *  *  *  His  Excel- 
lency. Doyle  E.  Carlton,  Governor  of  Florida,  is  very  much  interesied 


FLORIDA   STATE  BOARD   OF  HEALTH 107 

ADMINISTRATION 

in  the  health  work  of  our  state  and  is  doing  everything  in  his  power 
lo  promote  the  health  and  happiness  of  our  people,  as  he  realizes 
that  it  means  a  conservation  of  Florida's  greatest  assets — capital  and 
labor." 

Senior  Surgeon  L.  L.  Lumsden,  U.  S.  Public  Health  Service,  rep- 
resenting the  Surgeon  General,  stated  in  part:  "The  Public  Health  Ser- 
vice regards  this  as  a  historic  episode  in  the  affairs  of  this  country. 
I  do  not  know  of  any  other  Governor  having  called  a  conference 
of  this  kind  nor  any  who  so  clearly  grasps  the  fundamental  impor- 
tance of  health  service  to  the  people  of  his  state  so  1  wish  to  pay  my 
respects  to  the  Governor  of  Florida  who  has  seen  one  of  the  foremost 
duties  of  a  statesman.  *  *  *  Public  health  work  has  been  defined  as 
'public  service  for  the  conservation  and  promotion  of  health  and  for 
the  prevention  of  disease  and  premature  death.'  Its  aim  is  *to  make 
growth  more  nearly  perfect,  decay  less  rapid,  life  more  vigorous, 
death  more  remote.'  •  *  *  This  has  heroic  sound  but  it  not  only 
is  possible  but  is  an  absolutely  demonstrated  fact.  *  *  *  You, 
in  Florida,  have  one  of  the  greatest  opportunities  in  the  world 
of  public  health  service  administration,  that  of  demonstrating 
what  public  health  service  does  and  can  do  when  properly 
administered.  You  are  beginning  a  new  era.  With  Governor 
Carlton's  leadership  and  under  Dr.  Hanson's  business-like  adminis- 
tration I  prophesy  a  brilliant  success.  1  am  impressed  with  the  ability 
of  Dr.  Hanson  to  get  cooperation  from  outside  agencies.  *  *  *  There 
are  certain  communicable,  preventable  diseases  which  have  come  to 
you  in  the  South  and  you  have,  unfortunately,  and  to  a  large  extent 
undeservedly,  a  reputation  for  unhealthy  conditions  in  Florida,  Ala- 
bama and  Mississippi.  I  am  much  interested  in  that  statement  for 
as  a  matter  of  fact  if  you  will  look  into  mortality  records  you  will 
find  that  in  comparable  economic  and  social  groups  the  death  rate  in 
the  South  is  lower  than  in  the  North.  It  so  happens  that  these  dis- 
eases which  are  peculiar  to  the  South  are  those  most  readily  controlled. 
It  is  easily  within  your  power  to  reduce  malaria,  hookworm,  tubercu- 
losis, dysentery,  diphtheria,  etc.,  almost  to  the  vanishing  point.  *  *  * 
Tax  money  spent  for  local  public  health  service  will  yield  a  bigger 
dividend  than  if  invested  any  other  way.  The  Highest  Tax  We  Pay  is 
for  preventable  disease.  Money  invested  for  health  work  will  yield  a 
dividend  in  dollars  and  cents  for  the  people  amounting  to  from  300% 
to  3,000%.  *  *  *  The  program  for  Florida  as  presented  by  Dr.  Han- 
son has  a  perfectly  sensible  series  of  objectives.  *  *  *  We  need  some 
one  on  the  job  in  each  county  with  sufficient  training  to  carry  out  the 
program  in  an  effective  economic  manner.  In  the  southern  states, 
Alabama  was  the  first  state  to  have  public  health  service.  Walker 
County,  with  a  population  of  about  60,000,  largely  rural,  being  the 
Hrst  to  adopt  it.  *  *  *  The  death  rate  for  the  average  year  for  five  or 
?ix  years  before  the  health  department  was  founded  was  1  9  per  thous- 
and population.  Two  or  three  years  after  the  health  service  was  be- 
an, the  death  rate  had  come  down  to  1  2  per  thousand  and  preventa- 
le  disease  had  been  reduced  one-half.        Sanitation    had    been     the 


108 FLORIDA  STATE  BOARD   OF  HEALTH 

ADMINISTRATION 

main  feature  of  the  program  brought  about  by  intensive  education. 
This  reduction  amounts  to  at  least  6  deaths  per  thousand  each  year — 
this  means  360  deaths  less  a  year  in  that  county.  For  every  death 
prevented,  at  least  10  cases  of  illness  were  prevented.  Every  case 
cost  at  least  $10.00 —  a  return  of  $360,000  on  an  investment  of 
about  $9,000  a  year  for  the  county  health  service.  *  *  *  In  the  average 
county  in  Florida,  -results  more  or  less  comparable  can  be  obtained 
by  local  health  service.  This  is  one  of  the  greatest  propositions  which 
has  ever  been  presented  to  the  people  of  your  state.  The  organiza- 
tions represented  here  should  get  behind  this  program  and  put  it 
over.  *  *  *  The  United  States  Government  is  interested.  People  go 
from  Florida  to  Maine,  California  and  other  states.  Nothing  is  local 
any  more.  The  line  of  demarcation  between  people  of  the  city  and 
rural  community  has  become  indistinct.  *  *  *  Health  conditions  in  Flor- 
ida are  of  tremendous  importance  to  everyone  in  the  United  States 
because  of  the  abundance  of  commodities  shipped  from  your  state. 
*  *  *  The  usual  statement  "when  we  go  before  County  Commissioners 
is  that  "we  are  hard  up — -we  have  had  several  bad  years — taxes  are 
too  high — we  cannot  afford  to  do  this.'  The  poorer  the  county  the 
more  disease  the  people  will  have  and  the  more  they  need  health 
service.  It  is  a  vicious  circle.  *  *  *  The  United  States  Public  Health 
Service  is  as  interested  in  cooperating  in  the  development  of  your 
county  public  health  units  as  it  is  in  any  other  state  in  the  country. 
In  Florida,  you  have  an  opportunity  for  a  record-breaking  achieve- 
ment. Whether  you  do  this  or  not  in  Florida  means  thousands  of 
persons  alive  or  dead  in  five  or  ten  years  from  now.' 

Dr.  J.  J.  Tigert  presented  the  following  resolution  which  was 
unanimously  adopted  by  the  group   assembled: 

Be  it  resolved  by  the  representatives  of  the  various  statewide 
organizations  attending  the  health  conference  here  assembled  that  we 
endorse  in  principle  the  program  of  the  State  Board  of  Health  to  give 
the  citizenship  of  Florida  a  full  time  health  service  in  every  com- 
munity  within    the   State. 

Be  it  further  resolved  that  we  pledge  the  active  cooper- 
ation of  the  organizations  which  we  represent  to  the  end  that  the  cit- 
izens of  our  State  may,  be  intelligently  enlightened  as  to  the  impor- 
tance and  necessity  of  a  full  time  health  unit  in  every  county  in  Flor- 
ida. 

Be  it  further  resolved  that  we  appreciate  the  action  of 
His  Excellency,  The  Governor,  in  calling  this  important  meeting  which 
is  so  vital  to  the  future  welfare  of  the  entire  state. 

Be  it  further  resolved  that  we  express  our  appreciation 
to  the  State  Board  of  Health  and  pledge  our  individual  and  collective 
cooperation  and  assistance  in  its  entire  program  for  the  protection  of 
the  lives,   health  and  economic  resources  of  our  citizens. 

POST-GRADUATE  OBSTETRICAL  COURSE 
This  month  the  State  Board  of  Health,  in  cooperation  with  the 
Children's  Bureau  of  the  Department  of  Labor,  initiates  the  Post-Gr.i- 
duate  Courses  in  obstetrics.  The  first  class  is  sponsored  by  the  L<  e 
County  Medical  Society  at  Ft.  Myers.  Dr.  J.  R.  McCord,  Professor 
of  Obstetrics  at  Emory  University,  eminent  national  authority  is  per- 
sonally conducting  the  instructions,  consisting  of  lectures,  lantern  slid  * 
and  movie  film  demonstrations,  from  June  30th  to  July  4th. 


FLORIDA  STATE  BOARD   OF   HEALTH KI9 

CHILD    HYGIENE   AND  PUBLIC   HEALTH    NURSING 
Lucile  Spire  Blachly,   M.   D.,   Director 

MATERNAL  MORTALITY  SURVEYS 

A  study  of  the  deaths  of  mothers  from  childbirth,  or  causes 
associated  with  childbirth,  for  1 928  as  tabulated  by  the  Children's 
Bureau  shows  Florida  in  an  unenviable  position.  With  a  mortality 
rate  of  90.6  deaths  for  every  10,000  live  births,  she  tops  the  list 
for  white  mothers;  with  a  rate  of  I  10.2,  she  also  tops  the  list  for 
rural  mothers.  Considering  colored  mothers  alone,  with  a  rate  of 
124.7,  she  ranks  ninth  from  the  bottom  being  exceeded  by  Oklahoma, 
Louisiana,  Tennessee,  Arkansas,  Georgia,  South  Carolina.  Alabama, 
and  Kentucky  with  Oklahoma,  with  a  rate  of  193.8,  topping  the  list. 
(The  colored  rate  is  shown  only  in  the  22  states  reporting  2000  or 
more  live  births.)  Considering  urban  deaths  alone,  twenty  states 
report  a  higher  rate.  The  maternal  mortality  rate  for  the  birth  regis- 
tration area  was  69.2;  that  for  the  urban,  77.6;  the  rural,  62:  the 
white  62.7;  and  the  colored   121. 

The  causes  of  these  deaths  for  1928  as  tabulated  by  the  Florida 
Bureau  of  Vital  Statistics  are  as  follows: 

Accidents  of  pregnancy  „ „„ 2  1 

Puerperal  hemorrhage  , _..„ 3  3 

Accidents  of  labor  ™ 36 

Puerperal   septicemia . —     86 

Puerperal  phlegmasia  albadolens  „.„.. , ..™,™         4 

Puerperal   convulsions    — ...      93 

Following  childbirth     .". _ _._ _        7 

280 

A  careful  maternal  mortality  survey  covering  the  facts  surround- 
ing each  death  would  be  required  before  a  fair  judgment  could  be 
made  as  to  the  number  of  deaths  that  might  have  been  prevented. 
Such  a  survey  should  be  made.  Surveys  of  this  kind  have  been  made 
in  a  dozen  or  more  states  in  the  last  two  or  three  years.  Final  re- 
ports are  available  for  only  a  few,  among  them  Maryland.  Maryland 
with  a  rate  of  49.5  for  1927.  64.6  for  1928,  and  54.6  for  1929.  on 
the  completion  of  such  a  survey,  covering  the  deaths  outside  of  Balti- 
more, 291  in  all,  concludes  that  1  66  of  these  deaths  could  have  been 
prevented.  Half  of  the  septicemias  resulted  from  abortion,  before 
the  seventh  month.  Of  the  I  76  that  went  beyond  the  seventh  month 
only  8%  had  had  good  prenatal  care  (Children's  Bureau  Minimum 
Standards),  35%  had  had  inadequate  care  and  57%  none.  The 
pelvic  measurements  had  been  taken  in  only  1 8  cases.  The  chief 
primary  cause  was  the  ignorance  of  the  mothers  and  their  families. 
Rarely  was  a  doctor  called  until  the  patient  was  nearly  dead.  Pre- 
liminary reports  from  several  of  the  other  states  indicate  similar 
Mtuations,  Judging  from  the  experience  of  these  states,  it  is  fair  to 
assume  that  our  public  must  be  educated  to  appreciate,  demand,  and 
intelligently  use  the  known  scientific  methods  in  maternal  hygiene  if 
life  is  not  to  be  lost  needlessly. 


L 


I 


110 FLORIDA  STATE   BOARD  OF  HEALTH 

BUREAU   OF   DIAGNOSTIC   LABORATORIES 
Paul  Eaton,  M.  D.,  D.  P.  H.,  Director 

EXAMINATION    OF    MILK 

Butterfat.  which  is  one  of  the  valuable  constituents  of  milk,  is 
present  in  the  form  of  very  small  droplets,  each  of  which  is  surround- 
ed by  a  coating  of  some  sort,  that  prevents  it  from  coalescing  -with 
its  neighbors.  Everybody  knows  that  "oil  and  water  will  not  mix", 
i.  e.,  that  fats  are  not  soluble  in  water.  But  everybody  knows  that 
fats  may  be  made  into  more  or  less  stable  mixtures  with  water  and 
watery  fluids,  by  appropriate  treatment  after  the  addition  of  some 
substance  which  will  protect  the  small  globules  into  which  the  oil  is 
broken.  The  housewife  makes  use  of  this  principle  in  making  oil 
dressings,    etc. 

Butterfat,  being  lighter  than  the  water  which  makes  up  the 
greater  part  of  milk,  tends  to  rise  on  standing  undisturbed,  forming 
cream.  The  souring  of  milk  or  cream  tends  to  destroy  the  protective 
coating  on  the  fat  globules,  thus  making  it  easier  to  make  butter  by 
churning.  There  is,  however,  always  some  butterfat  left  in  "but- 
termilk" because  it  is  impossible  to  cause  all  the  little  globules  of  fat 
to  stick  together. 

In  examining  milk  to  find  out  how  much  "butterfat"  it  contains, 
it  is  necessary  to  cause  all  of  the  fat  globules  to  run  together  so  that 
they  may  be  taken  into  account.  It  has^  been  found  that  strong 
hot  sulphuric  acid  will  destroy  the  protective  coating  on  the  fat  glo- 
bules so  that  they  will  run  together.  Therefore,  in  testing  for  butter- 
fat, a  measured  amount  of  milk  is  put  in  a  small  bottle  and  the  prop- 
er amount  of  sulphuric  acid  is  added  to  it.  The  bottle  is  then  shaken 
up  and  heated  in  a  vessel  of  hot  water.  The  butterfat  drops  then 
run  together  and  being  lighter  than  the  mixture  of  water  and  acid, 
rise  to  the  top  of  the  bottle,  where  the  total  quantity  may  be  mea- 
sured. 

The  practical  application  of  this  principle  was  made  by  Prof. 
Babcock  of  the  Agricultural  College  of  Wisconsin.  Its  use  has  saved 
millions  of  dollars  to  dairymen  by  enabling  them  to  cull  out  from 
their  herds  the  cows  that  were  not  producing  enough  butterfat.  to  pay 
for  their  feed,  \ 

When  you  read  in  the  report  of  a  milk  analysis  that  theJbutter- 
fat  was  3.5%  ox  4.2%  or  whatever  it  may  be.  you  may  know  that  in 
all  probability  the  test  was  done  by  the  Babcock  method,  which  was 
worked  out  by  an  obscure  Professor,  by  "puttering  around  in  ?t 
laboratory." 

Since  the  foregoing  was  written,  the  following  notice  appeared 
in  the  public  press: 


FLORIDA   STATE  BOARD   OF  HEALTH 


111 


BUREAU   OF    DIAGNOSTIC    LABORATORIES 

"The  Capper  prize  of  $5,000  and  a  gold  medal  for  Ihe  most  dis- 
tinguished service  lo  American  agriculture  was  todav  awarded  to  Stephen 
MduIIoij  Babcoek,  professor  of  agricultural  chemistry  at  the  University 
of  Wisconsin,  for  hiH  invention  of  the  Babcoek  test  for  butterfat  in 
milt.1* 

SUMMARY  OF  WORK  DONE  IN  THE    LABORATORIES   OF 
THE  STATE  BOARD  OF  HEALTH  DURING  THE  MONTH 

OF  MAY,  1930 

Jacksonville     Tampa      Pcoeacola      Miami      Tallahassee      Total 


Animal    Parasites   

1460 

566 

57 

192 

39 

2314 

Diphtheria  .,.„   

1910 

118 

12 

166 

11 

2217 

Typhoid  

330 

132 

39 

100 

61 

662 

Malaria  „ 

638 

158 

50 

30 

167 

1043 

Rabies    

24 

3 

3 

30 

Tuberculosis   „, 

207 

91 

12 

85 

38 

433 

Gonorrhea  

447 

186 

30 

126 

20 

809 

Kahn  .„  „ 

3448 

1134 

709 

5291 

Water:      Count  

\ 

51 

134 

1 

186 

Water:      Colon 

134 

134 

Milk:      Bacterial   Exam. 

74 

196 

116 

316 

20 

722 

Milk:      Chemical  Exam. 

146 

285 

117 

139 

20 

707 

Miscellaneous   „,   .. 

134 

114 

15 

441 

20 

724 

8818  3034   448  2575   397  15272 


Specimen  Containers  Distributed  — . 


7909 


BIOLOGICAL    PRODUCTS    DISTRIBUTED 

Diphtheria  Antitoxin 10.000   units      36  Packages 

5,000  units      16  Packages 

Toxin  Antitoxin 2466  C.  C. 

Schick  1  150  Tests 

Tetanus   Antitoxin   _ 20,000   units        9  Packages 

10,000    units  8  Packages 

1,500   units   834  Packages 

1 0   c.  c.  2  Packages 

2676  Treatments 

2970  Capillaries 

1  3  Treatments 
1  Cylinder 
2825  Capsules 


Anaerobic  Virus 

Typhoid  Vaccine  -. 

Vaccine   Virus    _ 

Antirabic   Virus   — - — 

Antimeningococcus  Serum 
Carbon  Tetrachloride  


ALL  REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 

THE  STATE  LABORATORY,  STATE  BOARD  OF  HEALTH. 

JACKSONVILLE,  FLORIDA 


112 FLORIDA   STATE  BOARD  OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

_  MEASLES 

The  organism  or  infectious  agent  which  produces  measles  has 
never  been  identified  but  the  virus  or  infection  of  the  disease  is  known 
to  be  present  in  the  secretions  from  the  nose,  mouth  and  throat  of  an 
infected  individual  for  a  minimum  period  of  9  days  including  the  stage 
characterized  by  catarrhal  symptoms  and  lasting  about  4  days  prior 
to  the  appearance  of  the  rash  and  from  then  on  during  the  first  5  days 
of  the  eruption.  After  this,  the  disease  is  rarely  transmitted  from  a 
patient  to  a  susceptible  individual. 

Of  all  communicable  diseases,  measles  is  the  most  readily  trans- 
mitted. Practically  all  susceptible  individuals  exposed  will  contract 
measles.  The  infection  is  transmitted  directly  from  person  to  person 
or  indirectly  by  articles  recently  soiled  with  the  secretions  from  the 
nose  and  mouth  of  an  infected  individual.  Carriers  such  as  we  know 
for  typhoid,  diphtheria  and  scarlet  fever  are  unknown  for  measles 
and  the  infection  is  probably  never  carried  from  house  to  house  by 
the  clothing  of  physicians,  nurses  or  other  visitors.  It  usually  takes 
about  1  0  days  for  the  earliest  symptoms  to  develop  after  an  individ- 
ual has  been    exposed. 

In  order  to  effectively  control  measles,  five  precautionary  mea- 
sures are   necessary. 

1 .  Recognition  of  the  disease  by  the  clinical  symptoms.  Special 
attention  should  be  given  to  a  rise  of  temperature  in  a  susceptible  in- 
dividual who  has  been  exposed  and  such  an  individual  should  be  ex- 
amined by  a  physician  who  will  look  particularly  for  an  early  erup- 
tion in  the  mouth,  particularly  on  the  palate.  The  spots  which  ap- 
pear here  are  known  as  Koplik  spots  and  they  appear  before  the  skin 
eruption   develops. 

2.  Isolation.  Every  case  or  suspected  case  of  measles  should 
be  isolated  from  susceptible  individuals  during  the  period  of  commun- 
icability  referred  to  above. 

3.  Immunization.  The  use  of  serum  or  whole  blood  from 
convalescent  measles  patients  or  from  healthy  adults  who  have  had 
measles  will  prevent  or  modify  the  symptoms  in  an  individual  who 
has  been  exposed.  If  given  within  five  days  after  the  exposure,  these 
may  be  averted  in  a  high  percentage  of  instances,  and  if  not  averted. 
the  disease  is  modified.  If  given  later  but  before  the  onset  of  symp- 
toms, the  blood  or  serum  of  the  measles  convalescent  will  modify 
the  severity  of  the  attack  and  the  patient  acquires  permanent  im- 
munity. 


FLORIDA   STATE  BOARD   OF  HEALTH H3 

BUREAU  OF  COMMUNICABLE  DISEASES 

4.  Quarantine.  All  susceptible  children  and  teachers  -who 
have  been  exposed  to  measles  should  be  excluded  from  school  and 
public  gatherings  until   1 4  days  after  the  last  exposure. 

5.  Disinfection.  During  the  period  of  communicability  all 
articles  soiled  with  the  secretions  from  the  nose  and  throat  of  the 
patient  should  be  disinfected  by  boiling,  burning  or  chemical  disin- 
fection and  at  the  end  of  the  period  the  room  should  be  thoroughly 
cleansed  with  soap  and  water.  All  the  personal  linen  and  bedding 
should  be  laundered  and  the  mattress  exposed  to  direct  sunshine. 

During  an  epidemic  of  measles,  there  should  be  daily  inspection 
of  children  in  the  public  school,  particularly  those  who  have  not  had 
measles.  If  possible,  this  inspection  should  include  taking  and  re- 
cording of  temperature  and  any  child  with  a  temperature  above  99 
degrees  should  be  excluded  pending  a  diagnosis.  Schools  should  not 
be  closed  or  classes  discontinued  particularly  if  this  daily  inspection 
by  a  physician  or  nurse  can  be  provided  for. 

Measles  is  particularly  dangerous  to  small  children  hence  the 
necessity  of  protecting  babies  from  exposure. 

Measles  in  itself  is  rarely  fatal  but  pneumonia,  which  is  a  com- 
mon complication,  is  frequently  the  cause  of  death.  It  is,  therefore, 
necessary  to  put  all  patients  with  this  disease  in  bed.  The  room 
should  be  adequately  ventilated  but  the  patient  should  be  protected 
from  sudden  changes  of  temperature  and  a  doctor  should  always  be 
in  attendance. 


ONE   WAY    OF    DOING    IT 

A  young  woman  with  her  three  children,  while  visiting  her  sick 
mother-in-law,  noted  on  her  a  peculiar  eruption  and  asked  with  con- 
siderable alarm  about  the  nature  of  the  disease.  On  being  told  it 
was  smallpox,  she  departed  in  haste  and  went  straight  to  the  health 
officer  with  her  offspring  to  have  them  vaccinated.  At  the  same 
time  she  indignantly  related  the  story  of  her  visit.  On  investigation, 
the  diagnosis  was  confirmed,  the  house  placarded  and  vaccination 
offered  to  all  the  household.  The  sick  lady  decided  against  vac- 
cination for  her  husband  on  the  ground  that  it  might  interfere  with 
his  work,  so  all  the  rest  were  vaccinated.  Then  the  husband  was 
asked:  "Are  you  going  to  be  vaccinated  or  don't  you  have  the  say- 
so?"  This  was  too  much  for  the  old  gentleman  whose  weakness,  up 
to  this  point,  had  been  rather  too  evident.  He  was  obliged  to  pro- 
claim the  mastery  of  his  own  destiny,  and  to  prove  his  authority,  he 
offered  his  left  arm  with  the  sleeve  rolled  high. 


114 FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU    OF   ENGINEERING 
Ellsworth  L.  Filby,  C  E.,  Chief  Engineer 

WATER    PURIFICATION    PLANTS   IN    FLORIDA 

In  looking  over  the  water  supplies  that  are  treated  in  some  way 
or  another  in  Florida,  we  find  that  there  is  a  general  trend  to  the 
utilization  of  the  protective  treatments  such  as  filtration  or  chlorina- 
tion  and  also  towards  the  removal  of  mineral  ingredients  of  the  water 
which  tend  to  make  it  hard  (soap  consuming)  or  stained  (iron  color). 
Florida  has  apparently  an  abundant  supply  of  ground  water  in  the 
limestone  rock  underlying  the  state  but  it  is  often  very  hard  or  colored. 
Moreover,  in  limestone  country,  the  waters  are  often  contaminated 
by  surface  water  or  sewage  entering  the  underground  waters  some 
distance  away.  Recurrent  bacterial  evidence  of  contamination  is  in* 
dicative  of  pollution  that  may  be  occasionally  entering  the  supply 
from  distant  points.  A  river  may  rise  and  through  subterranean 
passages  influence  water  in  deep  wells.  This  has  been  proved  at 
High  Springs  and  the  influence  of  drainage  wells  is  apparent  at  Live 
Oak.  Both  of  these  places  have  treated  their  waters  until  oppor- 
tunity presented  itself  to  get  new  supplies  apparently  not  influenced. 

Chlorination  has  been  widely  used  in  Florida  and  will  appar- 
ently be  more  extensively  used.  Herman  Gunter,  State  Geologist, 
at  Tallahassee  in  a  recent  paper  before  the  Florida  Section.  Ameri- 
can Water  Works  Association,  at  Gainesville  stated:  "With  waters 
from  our  deep  formations,  the  danger  of  contamination  is  present 
even  though  we  all  agree  that,  on  the  whole,  such  waters  are  less 
liable  to  contamination  (than  shallow  wells).  It  is,  however,  this 
general  feeling  of  security  that  the  quality  of  our  deeper  waters  is 
above  suspicion  that  may  lead  us  into  difficulties  and  regrets  if  care 
in  their  development  is  not  exercised.  Illustrations  of  surface  water 
gaining  direct  entrance  to  underground  supplies  are  too  numerous  to 
require  special  mention  as  disappearing  streams  are  common  to  all 
sections  of  the  state  where  sinks  are  found.  Wells  drilled  for  sewage 
disposal  are  of  variable  depth  and  in  this  respect  are  comparable  to 
water  wells  of  the  same  locality.*'  So  it  is  that  we  have  chlorina- 
tion plants  on  well  waters  at  Cedar  Key,  Cocoa,  Coral  Gables,  Holly- 
wood, Jacksonville,  Lakeland,  Lake  Worth,  Live  Oak,  Miami,  Mt. 
Dora,  New  Smyrna,  Ocala,  St.  Augustine,  St.  Petersburg,  South  Jack- 
sonville, Sanford,  Tallahassee  and  the  U.  S.  Naval  Reservation  at 
Pensacola. 

Chlorination  is  employed  by  the  above  cities  as  an  insurance 
and  a  safeguard  against  chance  or  occasional  contamination.  These 
cities  are  alert  to  the  danger  of  water  borne  disease. 

Many  cities  use  surface  waters  and  treat  them  either  for  bacterial 
removal  or  color  removal.  Notable  in  this  list  are  the  filtration  plants 
at  Clewiston,  Ft.  Pierce,  Okeechobee,  Orlando,  Tampa,  Tarpon 
Springs  and  West  Palm   Beach. 

Softening  plants  to  remove  the  hardness  and  possible  color  or 
iron  are  maintained  at  Boca  Raton,  Cocoa,  Daytona  Beach,  Ft. 
Lauderdale,   Miami,   Ormond  and  Tampa. 


FLORIDA  STATE  BOARD  OF   HEALTH 


115 


BUREAU  OF  ENGINEERING 

Plants  for  the  removal  of  iron  alone  are  at  Stuart  and  Punta 
Gorda.  although  the  Cocoa  filtration  softening  plant  involves  iron 
removal  also. 

A  list  of  the  cities  and  types  of  treatment  employed  are  listed  below: 


CITY 

PLANT 
OWNERSHIP 

SOURCE 
OF   WATER 

AVERAGE 

PUMP  ACE 

Gallons  Per  Day 

PLANT    PROCESS 
EMPLOYED 

;opka 

Private 

Lake 

150.000 

CM  or  ination 

ca  Grande 

Private 

Creek 

18,000 

Chi  anna  lion 

ca  Raton 

Public 

Shallow  Wells 

300.000 

Coagulation — Softening 
Sedimentation — Filtration 
Re< Carbonization 

nal   Point 

Private 

Lake 

60.000 

Coa  □  u]  a  t  i  tat     flitf  ten  i  n  g 
Sedimentation — Filtration 
Chlorination 

dar   Key 

Public 

Shallow  Wells 

25.000 

Chlorination 

swiston 

Private 

Canal 

150.000 

Coagulation — Softening 
S= d  i  men  tation — Flit  ra  lion 
Chlorination 

co  a 

Public 

Shallow  Wells 

175,000 

Iron    Removal — Coagulation 

Sedimentation Softening 

Filtration — Chlorination 

ral  Gables 

Public 

Shallow  Wells 

850,000 

Chlorination 

nia 

Private 

Canal 

100.000 

So  f  ten  in  g — Coa  gu  la  t  ion 
Sedimentation — 'Filtration 

Chlorination 

jtona  Beach 

Public 

MainlandWells 

1.000.000 

Coa  gul  a  tl  on — So  f  ten  in  g 
Sedi  men  ta  lion 

ytona  Beach 

Public 

Peninsular  Well 

900.000 

Soften  in  g — Coa  gu  1  a  t  i  on 
Sedi  men  la  Uo  n — F  il  Ira  lion 

Lauderdale 

Public 

Shallow  Wells 

800.000 

Iron   Removal — Softening 
Coa  gulatlon — Sedimentation 
Re -Carbonization — Filtration 
Chlorination 

Pierce 

Public 

Canal 

400.000 

Iron    Removal — Coagulation 
Sedimentation — Filtration 
Chlorination 

[ford 

Private 

Shallow  Wells 

80.000 

Softening — Sedimentation 

If  Hammock 

Private 

Creek 

150,000 

Chlorine  tion— Sof  ienlng 
Coa  gul  a  I  i  on — Filtration 

llywood 

Public 

Deep  Wells 

500,000 

Chlorination 

mestead 

Public 

Shallow  Wells 

225.000 

Softening — Sedimentation 
Filtration 

mosassa 

Private 

Spring 

5.000 

Chlorination 

iantown 

Private 

Canal 

6.700 

Coagulation — Sedimentation 
Filt  rati  on  — Chlo  rlna  1 1  o  n 

ts   nville 

Public 

Deep  Wells 

12.000.000 

Chlorination 

«'  nd 

Public 

Deep  Wells 

1, 300.000 

Chlorination 

«    ^Vorth 

Public 

Shallow  Wells 

750.000 

Chlorination 

116 


FLORIDA   STATE  BOARD   OF   HEALTH 


BUREAU    OF   ENGINEERING 


CITY 


PLANT 
OWNERSHIP 


SOURCE 
OF   WATER 


AVERAGE 

PUMPAGE 

Gallons  Pet  Day 


PLANT     PROCESS 
EMPLOYED 


Live  Oak 

Miami 
Miami 

Miami   Shores 
Mount  Dora 

Moore  Haven 
New  Smyrna 
Ocala 

Okeechobee 
Orlando 
Ormond 
Palatka 
Punta  Gorda 
Pine  Castle 
St.  Augustine 
St.  Petersburg 
St.  Petersburg 
San ford 

Shawano 
Plantation 

South  Jacksonville 

Stuart 

Tallahassee 

Tampa 

Tarpon  Springs 
U.  S.  Naval 
Reservation 
(  Pensacola ) 
Vero  Beach 

West  Palm  Beach 


Public 

Public 
Public 

Public 
Public 
Public 

Public 
Public 

Public 

Public 

Public 

Public 

Public 

Private 

Public 

Public 

Private 

Public 

Private 
Public 
Private 
Public 

Public 
Public 
0.  S. 
Public 

Private 


Deep  Wells 

Hialeah  Wells 
Coconut  Grove 
Wells 

Shallow  Wells 

Deep  Wells 
Canal 
Deep  Wells 

Deep  Wells 

Lake 

Lake 

Deep  Wells 

Spring 

Deep   Wells 

Lake 

Deep  Wells 
Present 
Deep  Wells 

New- 
Deep  Wells 

Deep  Wells 

Canal 

Deep  Wells 

Shallow  Wells 

Deep  Wells 

River 

Lake 

Wells 

Deep  Wells 
Lake 


175.000 

15.000.000 
350.000 

36.000 

150.000 
100.000 
300.000 

600.000 

100.000 

2.500.000 

500.000 

750.000 

230.000 

4,000 

1,000.000 

4.500,000 

5,000,000 

750,000 

15,000 
500.000 

70,000 
800.000 

9,500.000 
350,000 
465.000 

350.000 
4.500,000 


Chlorination 

Softening — Coagulation 

Sedimentation — Filtration 

Re  -  Ca  rbomxa  tion — Gilorina  \kk 

So  f  ten  in  tf —  5ed  i  men  la  t  i  on 

Coa  gu  tat  ion —  Filtrat  Ion 
Softening 

Chlorination 

Coagulation — Sedimentation 
F 1 1 1 ra  Li  on — Ch  to  r  i  na  tio  n 

Chlorination 

Chlorination 

Coagulation — Sedimentation 
Filtratjon     -Chlorination 

Coairul  n  I  ion — Fil  I  ra  ti on 

Chlorination 


Softening — Sedimentation 
Chlorination 

I  ro  n    Removal —  F  il  t  ratio  n 

Chlorination 

Chlorination 

Chlorination 

Chlorination 

Chlorination 

Coa  u  ul  a  t  ion — So  f  tenmg 
5ed  i  m  en  ta  t  ion — -Fil  t  ra  t  ion 
Chtori  nation 

Chlorination 

Iron    Removal — Filtration 

Chlorination 

Coagulation — Softening 
Sedimentation — Filtration 
Re  -  Carbon  iza  tion— Chlorin  at* 

Coa  tful a  lion  — So t ten i n g 
Sedi  m  en  ta  Lion —  Fil  tra  tion 
Chlorination 

Chlorination 

Coagulation  — -Softening 
Sed  i  men  ta  t  ion — Fil  t  ration 

angulation — SeBimentatti  n 
Titration-     ChJolioation - 


FLORIDA  STATE  BOARD   OF  HEALTH M7 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D,  P.  H.,  Director 

A    HEALTHIER    FLORIDA 

The  American  Public  Health  Association,  through 
its  cartoon  service,  pictures  very  vividly  "a  healthier 
world."  The  cartoon  on  the  back  \  cover  of  this 
issue  shows  that  the  Health  Department,  linked  with 
public  interest  in  prevention,  is  the  Way  to  erase 
unnecessary  sorrow  and  death  from  any  city,  county 
or  state.  Your  Health  Department  knows  how  to  clean  house  but 
cooperation  and  public  interest  are  necessary  to  do  a  thorough  job. 

Great  progress  has  been  made  toward  decreasing  the  number  of 
deaths  from  preventable  diseases.  For  instance,  in  Florida  las*  year 
there  was  not  a  single  death  from  smallpox.  Do  you  know  the  rea- 
son? 

A  total  of  67  deaths  was  charged  to  diphtheria  last  year  which 
is  the  lowest  number  from  this  preventable  disease  in  the  history  of 
the  state.  In  1928,  there  were  69  deaths;  in  1927,  there  were  93 
deaths."  This  shows  splendid  progress.  However,  the  fight  is  not 
won.  Additional  interest  and  cooperation  "will  make  possible  the  wip- 
ing out  of  deaths  from  this  disease. 

Typhoid  fever  took  a  death  toll  of  83  last  year  in  Florida.  In 
1917,  a  total  of  221  lives  was  lost  to  typhoid  fever  and  in  1918, 
there  were  255  deaths  from  the  same  cause.  It  is,  indeed,  very  grati- 
fying to  find  the  number  of  deaths  reduced  to  83  for  a  single  year 
but  there  is,  as  in  the  case  of  diphtheria,  still  a  challenge  for  greater 
effort  in  the  fight  for  control  of  this  deadly  disease. 

The  cartoon  pictures  scarlet  fever.  In  Florida  last  year,  there 
were  four  deaths  from  this  disease.  Rabies  is  also  pictured  and  we 
find  there  were  two  deaths  in  Florida  from  rabies.  This  total  of  two 
deaths,  both  white,  may  not  at  first  appear  to  be  a  great  number. 
However,  rabies  is  preventable,  is  unnecessary  and  any  one  who 
has  stood  at  the  bedside  when  a  life  was  slowly  being  taken  by  this 
dread  disease  will  never  question  the  need  for  interest,  cooperation 
and  money  in  the  Health  Department. 

In  Florida,  malaria  stands  out  as  a  real  problem.  This  is  a  pre- 
ventable disease  but  still  we  find  470  persons  died  from  this  disease 
last  year,   259  white  and  21  1    colored. 

Your  State  Health  Officer  and  his  associated  Bureau  heads,  field 
workers,  etc.,  are  faithfully  working  for  the  reduction  of  preventable 


118 


FLORIDA  STATE  BOARD   OF  HEALTH 


BUREAU  OF  VITAL  STATISTICS 


disease  in  this  state.  City  and  county  health  departments,  together 
with  the  United  States  Public  Health  Service  are  also  doing  their  part. 
The  work  can  go  on  just  so  far  as  the  limited  funds  appropriated  for 
that  purpose  will  permit.  Florida  is  paying  a  high  price  in  death  tolls 
from  preventable  dj^ase.  We  know  how  to  clean  house.  BUT — (you 
know  the  answerer 


Standards  for  textbooks  in  health  teaching  are  discussed  in  the 
July  Hygeia  by  J.  Mace  Andress.  editor  of  the  school  department. 
He  suggests  that  the  following  questions  be  kept  in  mind  by  teachers 
as  they  study  new  texts;  Is  the  book  scientifically  accurate?  Does 
it  tend  to  promote  wholesome  attitudes?  Is  it  practical?  Is  it  inter- 
esting?     May  it  be  studied  wihout  eyestrain?      Is  it  teachable? 


The  following  tables  indicate  the  number  of  deaths  from  certain 
diseases  by  months,  for  1930  as  compared  with  the  previous  year. 
(Provisional  figures.) 

TYPHOID  DEATHS 


Yeat 

Jan, 

Feb, 

Mar.     Apr. 

Tots! 

May  June     July  Aug,   Sept.    Oct,     Nov.   Dec. 

Total 

1930 
1929 

10 
2 

5 
4 

3       3 
6     11 

21 
23 

8    11     13      7      4      6      5      6| 

83 

MALARIA  DEATHS 


Year 

Jan. 

Feb. 

Mar.     Apr. 

Total 

May  June    July  Aug.  Sept.  Oct.    Nov.  Dec, 

Total 

1930 
1929 

17 
24 

15 

7 

13      16 
IS      14 

61 
60 

30    40    65    59    72    71    40    33 

470 

DIPHTHERIA  DEATHS 


Year 

Jan. 

Feb.  Mar.     Apr. 

Total 

May  June    July  Aug,  Sept..  Oct,     Nov.   Dec. 

Total 

1930 
1929 

5 
8 

6        3        2 
6       3        3 

16 

20 

3      1      1      8    10     6     6    12 

67 

Year 


TUBERCULOSIS    DEATHS 

Jan.       Feb.  Mar.    Apr.  Total     May  June    July  Aug.  Sept.  Oct.    Nov.  Dec.      Tola' 


1930  84  86  101  90 
1929  81  109  88  85 


361 
363 


81  76  88  82  71  80  87  86 


1014 


FLORIDA   STATE  BOARD   OF   HEALTH 


119 


BUREAU    OF    VITAL    STATISTICS 


'PROVISIONAL  MORTALITY  FOR  MARCH,    1930.  AS  COMPARED  WITH 
THE  SAME  MONTH  OF  1929. 


Ii>t"n'l 
List  No. 
(1930) 


FLORIDA 


DEATHS 


March.  1930    I     March,   1929 


Total  Whin 


Col-    I  I 

ored  [Total  .WhiU 


1  -200   |   ALL   CAUSES 


1-2 

6 

7 

8 

9 

10 

1  I 

16 

17 

18 

23-32 

36 

45-53 

62 

59 

78-89 

82 

90-103 

90-95 

104-114 


107 
15- 

130- 


Typhoid 

Smallpox      „— ™. — 

Measles       ■,..,.—. 

Scarlet   Fever    

Whooping   Cough 

Diphtheria 

Influenza 


109 
129 
1  19 
139 
132 
140-150 


Acute   Anterior    poliomyelitis 

Lethargic    encephalitis 

Meningococcus    meningitis    ..... 

|    Tuberculosis   all    forms    

Malaria       

Cancer    —    all    forms    „ „_ _ 

Pellagra      __._ _ 

Diabetes     mellitus     „,„ „...„ m. . .,,  , 

Diseases  of  the  nervous  system  

Cerebral    hemorrhage,    apoplexy 

Diseases    of    the   circulatory    system 

Diseases   of  the   heart   _ 


Diseases    of   the   respiratory   system   

Pneumonia    —   all    forms   _ ] 

Diseases   of   the   digestive  system   I 

Diarrhea   and   enteritis    (under   2   years)    — I 

Nonvenereat    diseases    genitourinary    system    1 
Nephritis  all    forms   a — „—..... ' 

The   puerperal  state   — 


1732 


6 

4 

47 

2 

2 

1 

100 

16 

104 

21 

21 

198! 

163 

305 

269 

139 

110 

122 

23 

197 

167 

25 


1089 


3 

3 

22 


I 

I 

51 

1  1 

64 

7 

16 

1  17 

101 

225 

195 

84 

66 

57 

9 

143 

131 

16! 


643 


3 

I 

25 

1 


49 
5 

20 

14 

5 

81 
62 
80 
74 
55 
44 
65 
14 
54 
36 
9 


1605 


9 
3 

76 


88 

15 

75 

24 

24 

165 

124 

283 

262 

97 

79 

113 

12 

159 

140 

16 


1007 


4 

3 

39 


42 

12 

63 

12 

18 

106 

80 

207 

190 

58 

46 

69 

8 

97 

89 

9 


Col- 
ored 


598 


5 
3  7 


46 

3 
12 
12 

6 
59 
44 
76 
72 
3~> 
33 
44 

4 
62 
51 

7 


INFANT  MORTALITY— 


Number  of   LIVE   BIRTHS    

Number   of  STILLBIRTHS  

Number    of   DEATHS    under    1    year    _ — 

By   cause:    (deaths   under    1    year 

Infectious  diseases   (1-44,   exc.    II,   23,   32a).... 

Respiratory  diseases   (11,   23,   32a,    104-114) 

Castro- intestinal    diseases    (118.     119)  

Malformations  and   early  infancy    (157-161)... 

Premature  birth    (159)    — 

Injury  at  birth    (160)   — — 


2320 

1617 

1  17 

60 

145 

74 

9 

4 

26 

7 

16 

5 

71 

49 

35 

23 

10 

8 

703 
57 
71 

5 
19 
1  1 
22 
12 

2 


ALL  CAUSES.  BY  AGE 


\--es   (Deaths 

Ages    {Deaths 

'     Ages    (Deaths 

Aces   'Deaths 

Arcs    "Deaths 

Arcs   1  Deaths 

-11    145 

It      27 

21      19 

31      10 

4!      >7 

Und51    208 

0-4'   201 

5-9!      19 

10-141     27 

15-19!     42 

20-24!      72 

25-291      70 

'341      81 

35-39!      84 

40-44'    100 

45-491    121 

i  50-541    136 

55-59'    129 

641    111 

i65-69i    121 

70-74'    155 

75-79|    115 

80-84!      88 

85-89[      28 

1  -94|       1  I 

95-99'        2 

1001        1 

Unk.1       1  1 

1 

Total     1732 

'nr    ides  delayed   certificates. 


120 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


WE  KNOW  HOW  TO  CLEAN  H0U5E.  BUT- 

PUBLIC  COOPERATION  15  NECL55ARY  TO  DO  A  THOROUGH  JOB 


This  Issue  Exceeds   I  1.000  Copies 


Ft-ORID^ 


AlTHNOf 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED  JULY.    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  aa  Second  CI. is   Mailer,  October  27,   1921 
■I  the    Pot  toff  ice  at   Jacloonville.    Florida.   Under   lb*  Act    of    August    24.    1912 

"Hub  Bulletin  will  be  aent  to  any  addreaa  rn  the  State   free  of  charge. 

Vol.  22  AUGUST,  1930  No.  8 


Edited    by 

STEWART  G.  THOMPSON.  D.P.H..  Member 
American    Medical   Editor**   and   Author*'   Ann. 


) 


SPECIAL  ARTICLES 

BACTERIA  IN  MILK— Ea ton 

MATERNITY  LETTERS— Blackly 

TUBERCULOSIS  CLINICS— Brink 

TEN  LEADING  KILLERS — Thompson 

HOW  NECESSARY  IS  ILLNESS ?— Hanson 

SEWERAGE  AND  SEWAGE  DISPOSAL— Filby 


HENRY  HANSON.  M.  D..  STATE  HEALTH  OFFICER 


122 


FLORIDA    STATE   BOARD   OF   HEALTH 


Chas    H.     Maim,     Pres. 
Jacksonville 


BOARD    MEMBERS 

H.     Mason     Smith.    M.     D. 
Tampa 


Wm. 


D.    Nobles.    M.    D. 
Pensacola 


STATE    HEALTH    OFFICER 
Henry    Hanson.    M.    O. 


BUREAUS  AT  JACKSONVILLE 


Diagnostic    Laboratories.. 
•Vital    Statistic* 


Communicable   Diseases- 
Engineering— 


DIRECTORS 

Paul    Eaton.   M.   D.,   D.   P.   H. 
Stewart    G.    Thompson,    D.    P.    H. 
F.  A.  Brink,  M.   D. 
Ellsworth    L.  Filby,  C.  E. 


Child  Hygiene  and  Public  Health   Nursing...-   Lucile   Spire  Blachly,    M.    D. 

Accounting Screven   Dozier 

Crippled    Children «-  F.   L.    Fort,  M.   D, 


'55  0    Local    Registrars     (County    list    furnished    on    request). 

'Registration  Inspector Anna   C.   Emmons 

Drug   Store    Inspector H.   R.   Monroe 


LABORATORIES 


Jacksonville,., 
Miami- 


Pensacola 

THilahaaaaa 


Tampa,. 


Pearl    Griffith,    S.    E. 
E.    R.    Powell 
Jane    B.    Curriet   5+    5* 
Elizabeth    Byrd.    B     S. 
H+    D.  Venters,    b\   S, 


MEDICAL  OFFICERS 


De  Funis  k    Springs., 

Ja  ckson  vill  e — „ _ 

Vero    Beach. 


Tallahaaaee.- 

Tampa, 


C    W.    McDonald.    M,    D. 
B.    C.    Wilson.   M.    D. 
W.   A.   Claxton,    M.   D* 
H.   A.   McClure,    M.    D. 
A.   C   Hamblin.   M-   D. 


Jacksonville. 
Jack  s  on  v  j  1 1  e. , 
Miami , 


DISTRICT    SANITARY    OFFICERS 


Ocala 


Orlando 

Punta    Gorda  . 


Tallahassee.. 
Tampa „„ 


_*V.   B.   Lamoureux.   C.   E. 
-    Fred   A*    5a  fay 
•  George   B.   Reed 
_  C.    A,    Holloway 
_    Russell     B  rough  ma  a 
.  C.    A.   Renney 
_   C.    N.    Hobbs 
_  D,    H.    Osburn 
*  Assistant  Engineer 


Lake  City- 
Arcadia,. 


PUBLIC  HEALTH   NURSES 


DeFuniak  Springs 

Eden,   R.    F.   D.   Jensen .. 

Lake    City , mmm^. 

Ma  dison— — — .~_— . .- — , — . 

RUS  i"Tl 

S  ta  rkt 


Clio   McLaughlin,   R.   N, 
jule   Craves,   R.    N, 
Nanna    Colby,    R.   N. 
Sarah    Ida    Richards.    R.    N. 
Frances  Hall,  R.  N. 
Thora   Roberta.    R.   N. 
Joyce  Ely,   R.  N. 
Mary  C.    Dodd,    R.    N. 


COUNTY 


Jacksonville- 


HEALTH 


UNITS 
E,  C.  Stoy   (U.  S.  P.  H.  S.) 


FLORIDA  STATE  BOARD   OF  HEALTH 123 

ADMINISTRATION 
Henry  Hanson,  M.  D,,  State  Health  Officer 

'HOW  NECESSARY  IS  ILLNESS?" 

The  quotation  above  appeared  recently  as  the  title  of  an  editor- 
ial in  one  of  the  State's  leading  papers.  The  general  trend  of  the  ar- 
ticle quite  correctly  pointed  out  that  a  considerable  portion  of  illness 
was  unnecessary,  A  comparison  was  made  with  methods  employed 
in  Vienna  and  Russia,  and  then  a  quotation  followed  from  the  Chris- 
tian Science  Monitor,  an  organ  which  is  not  in  harmony  "with  the  prac- 
tices of  modern  Health  Departments.  The  comparison  made  between 
providing  dinners  and  vacations  for  school  children,  with  "compulsory 
inoculation  and  vaccination"  does  not  convey  a  true  impression  of  the 
modern  public  health  program.  Much  can  be  acomplished  by  "ordin- 
ary rules  of  right  living"  and  many  cases  of  illness  would  be  avoided 
if  all  people  would  observe  perfect  rules  of  cleanliness.  The  writer 
referred  to  does  not  know  that  he  and  all  who  escape  the  ordinary 
infectious  diseases  do  so  because  of  a  gradual  process  of  immunization 
in  that  from  time  to  time  they  have  consumed  enough  of  the  causative 
agents,  through  error  (in  technique — not  in  belief)  to  in  a  way  inocu- 
late themselves  unknowingly  against  the  diseases  they  have  escaped. 
They  have  been  immunized  in  a  natural  way.  Those  who  are  sud- 
denly exposed  to  communicable  disease  against  which  they  have  no 
acquired  immunity  are  usually  prompt  victims  of  the  disease. 

No  one  knows  better  than  the  health  officer  who  has  spent  years 
under  various  conditions  and  in  various  countries  that  much  illness  is 
unnecessary.  The  teachings  of  the  "Cleanliness  Institute,"  the  liberal 
use  of  soap  and  water,  is  excellent  as  an  aid  in  combatting  disease. 
It  alone-  however,  does  not  fill  the  entire  bill.  It  will  not  protect  you 
against  the  insect  borne  diseases,  nor  will  it  insure  you  against  con- 
tracting smallpox  if  you  knowingly  or  unknowingly  come  in  contact 
with  such  a  case. 

Insofar  as  Florida  is  concerned,  the  greatest  decrease  in  incidence 
has  occurred  in  those  diseases  for  which  there  are  protective  inocula- 
tions. The  diphtheria  rate  has  dropped  in  this  state  from  8.7  in  1926 
to  4  per  100,000  of  population  in  1929,  since  the  advent  of  toxin 
antitoxin,  the  Schick  test  and  the  more  prompt  use  of  antitoxin.  The 
typhoid  rate  for  last  year  was  less  than  6  per  1  00,000  of  population, 
and  smallpox  has  become  a  negligible  factor.  Here  we  can  repeat: 
"It  is  only  those  who  want  these  diseases  who  have  them,"  meaning 
by  this  that  they  prefer  to  take  a  chance  rather  than  to  avail  themselves 
of  certain  protection  which  has  been  developed  by  painstaking  medical 
research. 

Florida's  greatest  problem  today  is  presented  by  the  group  of 
illnesses  for  which  we  do  not  have  protective  inoculations,  or  vacci- 
nations, outstanding  among  which  we  can  cite  tuberculosis,  malaria 
and  hookworm  diseases.     For  malaria  alone,  we  have  a  rate  of  over 


124 FLORIDA  STATE  BOARD   OF   HEALTH 

ADMINISTRATION 

3 1  deaths  per  1 00,000  population  and  a  morbidity  of  600  per  1 00, 
000.  When  the  Utopian  era  arrives  and  communicable  diseases  have 
been  banished,  we  can  adopt  the  slogan  of  "No  Inoculations"  but 
while  things  are  as  they  are  today*  we  must  use  the  intelligence  which 
guides  us  in  a  beneficial  selection  of  means  available  for  safeguarding 
the  physical  well-being  of  the  people,  accepting  our  just  responsibility 
rather  than  "passing  the  buck"  to  a  very  busy  and  widely  occupied 
Almighty  God, 

THE  SURGEON  GENERAL'S  AND  THE  STATE  AND  PROVIN- 
CIAL HEALTH  OFFICERS'  CONFERENCE 

The  State  Health  Officer  attended  the  meeting  of  the  Surgeon 
General's  and  the  State  and  Provincial  Health  Officers'  Conference 
in  Washington,  June  18th  to  20th,  at  which  40  states,  Mexico,  Porto 
Rico,  Hawaii  and  Canada  were  represented  by  their  respective  Health 
Officers  and  other  accredited  employees. 

The  U.  S.  Public  Health  Service  had  the  leading  part  in  the  pro- 
gram presenting  sound,  well  worked  up  papers  for  which  the  Service 
is  generally  and  creditably  recognized.  The  Surgeon  General  and  his 
staff  have  established  standards  and  a  leadership  in  public  health  ac- 
tivities in  this  country  which  deserve  the  grateful  commendation  of 
the  Nation. 

Among  the  several  papers  presented  by  the  Service,  there  were 
those  on  the  present  status  of  the  efficacy  of  the  antimeningococcus 
serum  pointing  out  the  need  for  more  extensive  research  for  the  cure 
and  control  of  cerebro  spinal  meningitis,  a  highly  fatal  disease. 

Undulant  fever  was  ably  discussed  and  the  data  brought  out  in- 
dicated that  where  there  was  not  sufficient  control  of  dairy  herds,  milk 
should  be  pasteurized  before  being  offered  for  sale. 

Space  does  not  permit  going  into  details  of  the  other  interesting 
papers  presented  and  it  is,  therefore,  recommended  that  those  who 
have  access  to  the  proceedings  of  the  Conference  read  them  carefully 
as  much  helpful  information  will  be  found  therein. 

POSTGRADUATE  OBSTETRICS  COURSE 

Dr.  McCord's  postgraduate  obstetrical  courses,  made  available 
by~the  Children's  Bureau  of  the  Department  of  Labor  and  given  under 
the  auspices  of  the  State  Board  of  Health,  have  met  with  a  very  gra- 
tifying success.  The  courses  so  far  have  been  given  at  Ft,  Myers,  Sar- 
asota and  Tampa.  The  physicians  who  have  attended  these  courses 
are  highly  complimentary  and  feel  that  they  have  derived  a  benefit 
such  as  they  have  rarely  obtained  from  any  other  postgraduate  course 
which  they  have  attended.  It  is  hoped  that  the  physicians  will  take 
advantage  of  the  opportunity  which  is  presented  to  them  in  other  sec- 
tions of  the  state, 

Beginning  on  the  28th  of  July,  the  second  series  is  given  on  the 
East  Coast;  from  the  28th  to  the  1st  of  August  at  Ft.  Pierce;  from  the 


FLORIDA  STATE  BOARD   OF  HEALTH  125 


ADMINISTRATION 

4th  of  August  to  the  8th  of  August,  at  Miami;  and  from  the  i  1  th  to 
the  1 5th  at  West  Palm  Beach.  Beginning  the  week  of  the  25th  of 
August  to  the  29th,  Dr.  McCord  will  give  a  course  at  Lakeland;  from 
the    1st  to  the  5  th  of  September  he  will  be  at  Orlando. 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 
Lucile  Spire  Blachiy,  M.  D.,  Director 

MATERNITY  LETTERS 

This  Bureau  now  has  available  two  series  of  maternity  letters  for 
Florida  mothers.  One  set  was  written  especially  for  those  who  are  or 
should  be  using  physicians  and  the  other  for  those  who,  by  reason  of 
their  handicaps,  educational  or  economic,  must  or  at  least  now  feel 
they  must  use  midwives. 

These  letters,  in  principle,  are  no  experiment.  They  have  been 
tested  and  found  valuable.  Experience  has  proved  their  use  consis- 
tently promotes  the  three  principles  enumerated  by  Dr.  Ray  Lyman 
Wilbur  and  accepted  by  the  Committee  on  the  Costs  of  Medical  Care 
(at  the  end  of  the  third  of  the  five  year  study),  to-wit: 

1 .  They  preserve  the  personal  relationship  between  physician 
and  patient. 

2.  They  promote  preventive  medicine,  both  by    the    private 

practitioner  and  the  public  health  authorities. 

3.  They  encourage  the  community  to  supply  the  necessary 
facilities,  both  as  regards  physical  equipment  and  personnel 
necessary  to   adequately  prevent  illness  ■when  preventable 

.and  to  cure  it  when  curable. 

WHO  RSADS  THE  LETTERS?  Women  and  men  in  ail  walks 
of  life.  Naturally  those  college  trained  persons  having  a  speaking  ac- 
quaint»*fag  atieast  with  psychology,  sociology,  biology,  philosophy,  get 
much  from  them reading  between  the  lines  and  following  up  the  read- 
ing courses  or  class  work  suggested.  These  persons  set  the  standards  for 
their  communities.  Mothers  and  fathers,  careful  observers,  without 
this  formal  schooling,  find  them  helpful,  answering  directly  or  indirect- 
ly many  of  the  numerous  questions  life  has  left  unanswered.  To  the 
young  couple  just  building  the  love  nest  they  give  that  scientific  guid- 
ance that,  intelligently  followed,  leads  safely  past  the  numerous  pit- 
falls their  parents  stumbled  into.  To  the  under- privileged,  they  give 
comfort,  consolation,  assurance,  coupled  with  proved  principles  in 
maternity  and  imam  nygiene  which  enable  many  a  couple  to  find  its 
way  through  the  dark  and  devious  by-paths  to  the  light  of  a  better  un- 
derstanding of  the  mysteries  of  life. 

These  letters  will  be  sent  upon  request  to  any  expectant  mother 
desiring  them.  Doctors,  nurses,  teachers,  social  workers,  church  folk — 
anyone  wishing  to  review  the  set  or  sets  ■will  be  furnished  copies  on 
request. 


126  FLORIDA   STATE   BOARD   OF   HEALTH 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 
Paul  Eaton,  M.  D.,  D.  P.  H.,  Director 

BACTERIA  IN  M1L*K 

Sir  Joseph  Lister,  the  great  surgeon  who  made  a  practical  appli- 
cation of  the  germ  theory  of  disease  in  his  "antiseptic*"  surgery,  was 
very  much  interested  in  bacteriology.  One  problem  that  engaged 
his  attention  is  of  great  interest  to  us.  He  thought  that  milk,  "which  is 
a  physiological  secretion,  ought  to  be  sterile  if  properly  produced,  and 
when  his  tests,  ■which  -were  conducted  writ h  the  greatest  care,  showed 
that  milk  was  not  sterile,  he  assumed  that  he  had  made  some  mistake 
in  his  work.  That  is  to  say,  he  allowed  his  pre-conceived  notions  to 
blind  hirn  to  the  facts.     He  later  recognized  his  error. 

We  know  now  that  in  healthy  cows  there  are  many  bacteria  on 
the  walls  of  the  little  milk  tubes  in  the  udder  so  that  even  when  milk 
is  produced  under  the  most  exacting  conditions  it  contains  bacteria.  But_ 
these  natural  inhabitants  of  milk  are  not  harmful.  They  are  the  bac-(^ 
teria  that  cause  the  normal  "souring"  of  milk,  and  if  milk  does  not 
"sour"  in  a  reasonable  time  at  ordinary  temperatures  we  feel  that 
something  is  wrong.  Milk  also  gathers  bacteria  out  of  the  air  during 
the  process  of  milking.  Air  always  contains  bacteria  and  the  dusty 
air  around  a  barn  or  milking  shed  is  particularly  rich  with  them. 

A  great  part  of  the  bacteria  that  are  ordinarily  found  in  milk  pro- 
duced under  conditions  of  reasonable  cleanliness  are  furnished  by  the 
utensils.  Complete  freedom  of  utensils  from  bacteria  is  practically 
impossible  of  attainment.  There  are  bacteria  all  about  us,  and  the 
only  way  in  which  milk  pails  can  be  sterilized  is  by  baking  them  in  an 
oven  or  by  steaming  them  and  in  either  case  they  begin  to  pick  up  bac- 
teria as  soon  as  they  are  exposed  to  the  air.  (Some  bacteriologist 
washed  off  a  dollar  bill  with  sterile  water  and  by  experimenting  with 
a  few  drops  of  the  wash  water,  came  to  the  conclusion  that  there  had 
been  96,000,000  germs  on  the  bill.)  But  fortunately  for  us,  these 
germs  which  are  so  widely  distributed  in  nature,  ate  not  able  to  cause 
disease. 

The  germs  which  do  cause  disease  are  introduced  into  ^ilk  by 
or  from  persons  who  have  had  or  who  have,  the  disease  involved. 

It  is  known  that  some  diseases  are  most  infectious,  (that  is,  "catch- 
ing' )  in  their  very  earliest  stages.  That  is  to  say,  a  milker  misrht  be 
in  the  early  stages  of  scarlet  fever,  for  instance,  "coming  down"  with 
the  disease  as  we  say,  but  not  aware  of  it,  and  it  would  be  perfectly 
possible  for  him  to  infect  the  milk  he  handled  and  so  give  the  disease 
unwittingly  to  a  large  number  of  people. 

The  public  is  entitled  to  a  milk  supply  produced  in  the  cleanest 
possible  fashion,  but  it  is  also  entitled  to  the  only  possible  protection 
against  accidents  such  as  I  have  described,  which  is  pasteurization.  It 
is  true  that  pasteurization  will  not  change  dirty  milk  into  clean  milk 
but  it  is  equally  true  that  it  offers  protection  against  accidents  that 


FLORIDA   STATE   BOARD   OF   HEALTH 


127 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 

are  absolutely  beyond  control  in  any  other  way. 

Pasteurized  milk  'will  "sour"  like  normal  milk  because  the  heat- 
ing and  cooling  to  which  it  has  been  subjected  is  not  enough  to  kill 
the  normal  inhabitants  of  milk  while  it  IS  enough  to  kill  practically 
all  of  the  germs  which  can  cause  disease. 

SUMMARY  OF  WORK  DONE  IN  THE  LABORATORIES  OF  THE 

STATE  BOARD  OF  HEALTH  DURING  THE  MONTH 

OF  JUNE,  1930 

Jacksonville      Tampa       Pensacola       Miami      Tallahassee      Total 

Animal  Parasites  891  345  46  315  37  1634 

Diphtheria      267  74  7  65  3  416 

Typhoid _  320  144  51  52  57  624 

Malaria 474  150  93  20  155  892 

Rabies 23  II  2  27 

Tuberculosis     189  77  10  44  15  335 

Gonorrhea      __  392  159  28  99  31  709 

Kahn  345*  926  491  4873 

Water:  Count    66  136  7  209 

Water:   Colon    136  4  140 

Milk:  Bacterial  Exam 90  174  118        336  20  738 

Milk:  Chemical  Exam 151  175  119        143  20  608 

Miscellaneous     135  40  25         303  6  509 


6388     2331 
Specimen  Containers  Distributed  


498     2142 


355    M7I4 
5974 


BIOLOGICAL  PRODUCTS  DISTRIBUTED 

Diphtheria  Antitoxin- 10.000  units  28   Packages 

5,000  units  8   Packages 

Toxin   Antitoxin 2  1  30   C.  C. 

Schick - « 2  00    Tests 

Tetanus  Antitoxin 20,000  units  2    Packages 

10.000  units  3    Packages 

1,500  units  696  Packages 

Anaerobic  Virus ..„ 1  0  c.    c.  6    Packages 

Typhoid   Vaccine 2  1  74   Treatments 

Vaccine  Virus 907   Capillaries 

Antirabie  Virus 35    Treatments 

Carbon  Tetrachloride I  992    Capsules 

All    REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 

THE  STATE  LABORATORY,  STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA. 


128 FLORIDA   STATE  BOARD  OF  HEALTH 

BUREAU  OF  ENGINEERING 

E.  L.  Filby,  C.  E,,  Chief  Engineer 

SEWERAGE  AND  SEWAGE  DISPOSAL  IN  |^ORIDA— 1930 

In  considering  the  status  of  sanitary  sewerage  and  sewage  dispo- 
sal in  Florida,  it  is  very  desirable  that  the  party  considering  this  phase 
of  sanitation  think  well  of  the  topographical  and  geological  features  of 
the  state.  Florida  at  first  was  settled  along  the  old  Spanish  trail  route 
from  St.  Augustine  westward  through  Jacksonville,  Lake  City,  Madi- 
son, Monticello,  Tallahassee,  Quincy,  Marianna,  De  Funiak  Springs, 
Milton  and  into  Pensacola.  The  trail  starts  and  stops  on  salt  water 
and  traverses  the  coastal  plain  and  then  the  rolling  sand  and  clay  hills 
of  southern  Georgia  and  Alabama.  Between  the  terminals  we  find 
good  grades  but  very  often  only  a  limited  amount  of  water  for  final 
dilution  as  most  of  the  cities  are  set  on  hills.  These  towns  are  of  the 
slow,   steady  growth   character.      They  are  very  similar   to  any  rural 

southern  county  seat  towns composed    largely    of    retired     farmers, 

trades  people  and  the  like.  Having  a  steady  growth,  the  towns  are 
compact  and  thus  easily  served  by  sanitary  sewers.  Topography  nec- 
essitates, ofttimes,  many  outfall  lines  usually  terminating  in  small  sep- 
tic tank  installations.  Humping  is  rarely  utilized  except  at  Lake  City 
where  a  pump  unit  is  utilized  to  lift  the  sewage  from  the  north  side  of 
the  city  into  the  main  system  which  terminates  at  a  treatment  plant 
south  of  town. 

Lake  City  has  a  very  modern  and  efficient  treatment  plant  and 
for  a  city  of  4,300  population  is  to  be  congratulated.  The  plant,  con- 
structed in  1929,  consists  of  a  Dorr  clarifier,  dosing  tank,  sprinkling 
filter,  final  settling  and  separate  sludge  digestion  tank.  Chlorination 
is  used  to  prevent  odor  nuisance  from  the  sprinkling  filters.  Final 
disposal  is  into  a  small  branch  and  a  highly  stable  effluent  is  produced. 
Tallahassee  has  for  years  been  procrastinating  on  a  sewage  disposal 
problem  and  now  faces  an  expenditure  of  several  hundred  thousand 
dollars  for  sewage  treatment.  Preliminary  plans  call  for  Imhoff  tank 
treatment — sprinkling  filters  and  final  disposal  by  dilution  into  a  small 
lake.  Marianna  uses  limestone  sinks  along  the  banks  of  the  Chipola 
River  to  dispose  of  raw  sewage  into  the  underground  waters.  It  is 
planned  to  eliminate  this  pollution  by  extension  of  sewer  outfalls  to  the 
Chipola  River  and  the  utilization  of  tank  treatment  for  the  prevention 
of  floatage  nuisance. 

Pensacola  and  Milton,  like  St.  Augustine  and  Jacksonville,  util- 
ize the  presence  of  sea  water  and  brackish  waters  in  great  volumes  for 
the  disposal  of  their  wastes.  Both  Jacksonville  and  Pensacola  need  an 
extensive  sewerage  program  as  neither  city  has  kept  pace  with  sanitary 
sewers  in  comparison  to  population  increases. 

Florida  is  famous  throughout  all  the  country  for  its  resorts  dotted 
along  the  East  Coast  with  its  famous  Indian  River  and  inland  water  way 


FLORIDA  STATE  BOARD   OF  HEALTH 129 

BUREAU  OF  ENGINEERING 

of  lakes,  rivers,  canals  and  bays  with  numerous  openings  from  the 
ocean.  At  first,  developments  took  place  on  the  mainland  side  and 
then  on  the  ocean  islands  or  keys  where  such  cities  as  Palm  Beach  and 
Miami  Beach  arose,  from  the  mangrove  swamps.  To  protect  bath' 
ing  beaches  and  for  ease  and  cheapness  of  construction,  many  out- 
falls are  utilized  into  this  inland  water  way  and  dilution  is  the  main 
method  of  disposal.  At  Vero  Beach,  we  have  a  separate  sludge  di- 
gestion plant  of  the  coarse  screen.  Dorr  clarifier.  separate  sludge  di- 
gesting tank  type;  final  disposal  into  a  drainage  canal.  Palm  Beach 
is  planning  a  fine  screening  chlorination  plant  in  the  future  and  West 
Palm  Beach  will  have  to  take  some  steps  to  eliminate  the  pollution 
of  Lake  Worth.  During  the  boom,  an  extensive  sanitary  district  plan 
was  advocated  for  this  area  by  George  W.  Fuller  of  New  York  but  it 
has  never  materialized.  Financial  troubles  place  any  work  very  much 
in  the  future  except  for  the  town  of  Palm  Beach. 

Boom  towns,  towns  of  very  rapid  growth  and  scattered  develop- 
ment dot  the  East  Coast.  Good,  sandy,  well  drained  townsites  to  very 
low  rock  areas  vary  the  problem.  Pumping  is  usually  necessary  along 
the  islands  or  keys  such  as  at  Miami  Beach  and  Palm  Beach.  Extensive 
outfalls  are  used  on  the  mainland.  At  Delray  Beach,  the  clarifier 
unit  of  a  separate  sludge  type  plant  was  installed  but  has  been  aban- 
doned. At  Ft.  Lauderdale,  a  complete  modern  up  to  date  activated 
sludge  treatment  plant  is  constructed  and  under  canvass.  The  plant 
designed  and  built  by  Solomon,  Norcross  and  Keis  in  1926  has  never 
been  used  because  the  public  has  defeated  every  bond  issue  for  sew- 
erage extensions  and  sewage  pumping  stations.  Hollywood  depends 
on  individual  septic  tanks  ■with  one  line  of  sewerage  taking  the  efflu- 
ent from  these  tanks  in  the  business  area.  A  sandy  soil  with  porous 
coral  rock  near  the  surface  aids  in  the  disposal  of  the  liquid  wastes. 
Miami  disposes  of  her  sewage  mainly  raw  into  the  Miami  River  and 
Biscayne  Bay.  A  small,  fine  screen  plant  handles  a  portion  of  the 
sewage.  Experimental  work  has  been  done  at  Miami  and  the  future 
will  see  a  possible  separate  sludge  type  plant  on  an  island  in  Biscayne 
Bay.  Miami  Beach  pumps  its  raw  sewage  into  the  Government  ship 
channel  cut  on  outgoing  tides  and  finds  no  evidence  of  its  coming  back 
on  the  bathing  beach.  At  Miami  Beach  is  found  a  very  excellent 
example  of  architectural  camouflage  of  a  sewage  pump  station  set  in 
a  public  park.  It  ■was  designed  by  Hazen  and  Whipple.  Sewage 
pump  stations  are  housed  in  garages  and  thus  obviate  any  aesthetic 
complaints.  Coral  Gables,  that  extensive  development  and  city  south 
west  of  Miami,  depends  on  individual  septic  tanks  for  all  sewage  dis- 
posal. The  open  porous  rock  on  which  the  city  is  built  allows  vertical 
drainage  of  the  waste  liquids  into  the  first  water  strata  which  is  not 

ised  for  water  supply  purposes.  Miami,  likewise,  depends  very  large- 
ly  on  individual  septic  tanks.     Homestead  has  a  sanitary  sewer  system 

vith  a  pumping  unit.     Final  disposal  is  into  one  of  the  drainage  canals. 

(To  be  continued   in   September) 


130  FLORIDA   STATE   BOARD   OF   HEALTH 

\ 
BUREAU  OF  COMMUNICABLE  DISEASES 

F.  A.  Brink,  M.  D.,  Director 

MALARIA 

This  is  the  season  when  malaria  begins  to  be  prevalent.  Now  is 
the  time  to  set  up  our  defense  against  invaders  that  cause  "chills  and 
fever." 

Quinine  is  the  specific  for  curing  and  preventing  malaria.  Qui- 
nine is  the  active  ingredient  for  alt  proprietary  malaria  remedies  and 
quinine  can  best  be  purchased  as  quinine.  It  is  usually  put  up  in  5 
grain  capsules.  A  capsule  a  day  keeps  the  fever  away.  It  takes  more 
to  cure  the  disease  and  a  sick  man  should  go  to  the  doctor  for  his 
treatment. 

This  is  the  season  when  a  well  screened  (mosquito -proofed)  home 
offers  the  best  and  cheapest  kind  of  insurance  against  sickness,  death 
and  heavy  expenses  on  account  of  malaria.  The  State  Board  of  Health 
can  tell  you  how. 

Screening  Demonstrations 

Following  is  the  list  of  places  where  the  mosquito-proofing  squad 
will  give  demonstrations.  If  you  are  interested  in  comfort,  economy 
and  health  you  should  visit  one  of  the  homes  where  the  work  is  go- 
ing on. 

Schedule  of  Demonstrations 

^       Duval  County  _ August  6th  and  8th 

Levy  County     - „ August   I  3th  and    I  5th 

Dixie  County    August  20th  and  22nd 

Sumter  County August   27th  and    29th 

Hillsboro  County  „ September  3rd  and  5th 

CREEPING  ERUPTION 

As  a  result  of  the  studies  of  Dr.  J.  L.  Kirby-Smith  and  his  asso- 
ciates, the  causative  agent  of  creeping  eruption  has  been  discovered. 
This  very  distressing  condition  is  due  to  the  invasion  of  a  miscroscop- 
ic  hookworm,  the  embryo  or  baby  form  of  a  parasite  commonly 
found  in  cats  and  dogs.  The  eggs  of  the  parasites  are  passed  with  the 
stool  of  the  host  and  hatch  in  damp  soil.  Prevention  consists  in  avoid- 
ing contact  with  soil  contaminated  by  the  excrement  of  cats  and  dogs. 
Any  damp  spot,  muddy  place  or  pool  may  be  a  source  of  creeping 
eruption.  Hookworm  treatment  for  the  cats  and  dogs  is  of  definite 
value  as  a  preventive  measure. 

For  treatment  one  should  go  to  the  doctor. 

TOE  ITCH 

There  is  a  rather  troublesome  disease  that  attacks  the  skin  of 
the  feet  more  than  other  parts  and  shows  particular  preference  for 
the  areas  between  the  toes.  This  disease  is  frequently  called  "toe  itch." 
The  germ  or  organism  that  causes  it  is  similar  to  that  of  ringworm  so 
it  is  sometimes  called   "trichopytosis."     This  has  been  confused  with 


FLORIDA   STATE   BOARD  OF   HEALTH 131 

BUREAU  OF  COMMUNICABLE  DISEASES 

every  kind  of  skin  eruption  about  the  feet  but  most  often  it  is  called 
"ground  itch"  and  blamed  on  the  hookworm  which  is  justly  accused 
of  doing  much  other  harm. 

Toe  itch  can  be  prevented  by  scrupulous  cleanliness  of  the  feet, 
foot  gear  and  bath,  particularly  public  bathing  places.  For  treat- 
ment one  should  go  to  the  doctor  who  can,  with  the  intelligent  co- 
operation of  the  patient,  cure  the  disease. 

TUBERCULOSIS  CLINICS 

The  Field  Medical_  Officer,  in  the  lower  East  Coaat 
district  spent  the  entire  month  of  May  doing  tuberculosis  clinic  work. 
The  State  Board  of  Health  and  the  Florida  Public  Health  Association 
cooperated  in  the  conduct  of  clinics  at  Pensacola,  Quincy,  Ocala,  Dade 
City,  New  Port  Richey,  Kissimmee,  St.  Cloud,  Bradenton,  Sarasota  and 
Ft.  Myers.  About  three  days  were  spent  at  each  clinic  and  a  total  of 
1 008  persons  attended  the  clinics.  Of  these,  708  were  given  chest 
examinations  and  in  42  or  5.9%  there  was  evidence  of  tuberculosis 
in  various  stages  of  advancement.  Tuberculin  tests  were  given  to  606 
individuals  of  whom  473  returned  for  inspection.  Among  the  latter 
there  were  5  4  or  11.4%   who  reacted  to  the  test. 

Dr.  Claxton,  who  has  given  special  attention  to  the  diagnosis  of 
tuberculosis,   will  conduct  other  clinics  as  opportunity  presents  itself. 

The  early  recognition  of  tuberculosis  affords  the  greatest  hope 
of  recovery.  Persons  who  have  lost  weight,  feel  tired  most  of  the  time. 
persons  with  loss  of  appetite  or  who  have  a  "cold"  or  cough  persisting 
more  than  two  weeks,  should  have  a  thorough  and  complete  examina- 
tion with  special  attention  to  the  possibility  of  tuberculosis.  X-ray  ex- 
amination should  be  included  if  necessary. 

To  a  large  extent,  the  development  of  tuberculosis  can  be  pre- 
vented by  right  living.  Under-nutrition,  overwork,  dissipation  and 
bad  ventilation  are  apt  to  cause  a  latent  tuberculosis  to  become  active. 

THE  SEMINOLES 

Our  Field  Medical  Officer,  after  making  careful  inquiry,  reports 
iliat  the  Indians,  who  were  driven  from  the  Everglades  by  high  water, 
have  not  suffered  from  privation  or  exposure  and  health  conditions 
are  normal.  One  member  of  the  tribe  is  reported  to  have  tubercu- 
losis but  this  was  not  the  result  of  flood  conditions. 

A  general  health  survey  of  the  Seminoles  is  being  planned  for 
this  fall. 


Dr.  A.  P.  Harrison,  until  recently  stationed  at  Tallahassee  as  Dis- 
trict Medical  Officer,  is  no  longer  with  the  State  Board  of  Health.  Dr. 
H.  A.  McClure  of  Chipley  has  been  engaged  to  take  his  place  and  will 
begin  work  in  the  district  about  the  middle  of  August. 


132 


FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,   D.   P.   H.,  Director 

TEN  LEADING  KILLERS 

The  chart  below  indicates  the  ten  greatest  killers  in 
Florida  last  year  together  with  the  percentage  each 
represents  as  compared  with  the  total  number  of 
deaths  reported.  Space  will  not  permit  a  discus- 
sion as  to  the  reasons  for  these  particular  diseases 
ranking  among  the  first  ten  as  pages  could  be  writ- 
ten on  any  one  alone.  Death  rates  are  not  shown 
in  this  issue  owing  to  the  fact  that  the  I  930  census  has  not  been  of- 
ficially announced  for  Florida. 

Ten  Leading  Causes  of  Death,  Florida  —   1929 

CAUSES PERCENT  OF  ALL  DEATHS 


RECORDS 

M 
U 

1- 

< 

*h,     i     emTMS 

;■--.-■ 

r; 

I 

■ 

FLO  R  1  DA 

HEART  DISEASE 
NEPHRITIS 

CEREBRAL  HEMORRHAGE 
TUBERCULOSIS  [ALL  FORMS) 
CANCER  (All  FORMS) 
INFLUEKZA  (ALL  FORMS) 
PNEUMONIA  (ALL  FORMS) 
DISEASES  -  EARLY  INFANCY 
AUTOMOBILE  ACCIDENTS 
MALARIA 


inmiimmnnmininnummmm  u* 


mnmnmnmm  ** 


mnmmnnnh  * 


immnnnm 


mnminimmmrmm  n 


UlUIMMim 


immmunh 


5* 


VJ//W//////A 


fTECOBDV 


2ZZZZZZ2 


plohip 


ttMIMi 


3* 


HEART  DISEASE 

Heart  disease  still  leads  in  the  number  of  deaths  caused  in  Florida. 
This  disease  has  not  only  led  for  a  number  of  years  but  the  proportion 
of  deaths  attributed  to  this  cause  is  steadily  increasing  as  may  be  evi- 
denced by  the  following  table  which  indicates  the  number  of  deaths 
for  the  past  five  years,  by  color. 


Year 

Total 

White 

Colored 

1929 

2500 

1725 

775 

1928 

2481 

1743 

738 

1927 

2290 

1590 

700 

1926 

2351 

1572 

679 

1925 

2240 

1589 

651 

FLORIDA  STATE  BOARD   OF  HEALTH 


133 


BUREAU  OF  VITAL  STATISTICS 

CHRONIC  NEPHRITIS 

Next  to  heart  disease,  chronic  nephritis  takes  the  greatest  toll  of 
life  in  this  state.  It  will  be  noticed,  however,  that  1,690  deaths  were 
reported  last  year  from  this  cause  as  compared  with  a  total  of  1,772 
for  the  previous  year.  Although  the  disease  is  very  deadly  and  ranks 
second,  it  is  encouraging  to  note  a  decrease  in  the  total  number  charg- 
ed to  it.  Deaths  in  this  state  for  the  past  five  years  are  listed  below, 
by  color. 


Year 

Total      White 

Colored 

1929 
1928 
1927 
1926 
1925 

1690 
1772 
1615 
1548 
1160 

1027 
1132 
1016 
1016 
744 

663 
640 
599 
532 
416 

CEREBRAL  HEMORRHAGE 

The  cause  of  death  ranking  third  in  Florida  is  cerebral  hemor- 
rhage. Unlike  the  comparison  for  nephritis,  there  is  an  increase  in 
the  number  of  deaths  charged  to  cerebral  hemorrhage.  Deaths  in 
this  state  for  the  past  five  years  are  listed  below,  by  color. 


Year 

Total 

White 

Colored 

1929 

1291 

797 

494 

1928 

1172 

736 

436 

1927 

1152 

723 

429 

1926 

1157 

734 

423 

1925 

1070 

708 

362 

/ 


TUBERCULOSIS— (All  Forms) 

This  disease  now  ranks  fourth  in  Florida.  It  is  gratifying  to  find 
that  fewer  deaths  occurred  in  1  929  from  this  cause  than  for  the  pre- 
vious year.  In  fact,  the  total  of  1.014  is  the  lowest  charged  to  this 
disease  since  1925  as  will  be  noted  from  the  table  below  where  the 
totals  by  years  and  color  are  indicated. 


Year 

Total 

White 

Colored 

1929 

1014 

416 

598 

1926 

1102 

481 

621 

1927 

t097 

463 

634 

1926 

1187 

519 

668 

1925 

999 

426 

573 

134 


FLORIDA   STATE    BOARD    OF    HEALTH 


BUREAU  OF  VITAL  STATISTICS 

CANCER— (All  Forms) 

There  is  much  to  be  done  in  the  control  of  cancer.  It  ranks  fifth 
among  the  most  deadly  diseases.  Last  year,  a  total  of  994  deaths 
was  charged  to  this  disease,  which  represents  the  largest  number  dur- 
ing the  past  five  years.  The  following  table  indicates  the  deaths  from 
this  disease  for  the  past  five  years,  by  color. 


Year 

Total 

White 

Colored 

1929 

994 

805 

189 

1928 

887 

705 

182 

1927 

949 

757 

192 

1926 

878 

723 

155 

1925 

776 

624 

152 

INFLUENZA— (Al!  Forms) 

The  number  of  deaths  charged  to  influenza  fluctuates  from  year 
to  year.  However,  a  decided  increase  in  the  number  of  deaths  charg- 
ed to  this  disease  is  indicated  in  the  results  just  obtained  for  last  year. 
The  number  of  deaths  for  the  past  five  years  is  indicated  below,  by 
color.  ■- 


Year 

Total 

White      Colored 

1929 
1928 
1927 
1926 
1925 

903 
666 
323 
668 
338 

498   1    405 
378   |    288 
170       153 
370       298 
1 92   |    1 46 

PNEUMONIA— (All  Forms) 

There  is  a  reduction  in  the  number  of  deaths  charged  to  this  dis- 
ease last  year  as  compared  with  the  preceding  year.  The  total  num- 
ber of  deaths  from  this  cause  is  tabulated  below  for  the  past  five 
years,  by  color. 


Year 

Total 

White 

Colored 

1929 

864 

504 

360 

1928 

1085 

647 

438 

1927 

907 

524 

383 

1926 

1202 

656 

546 

1925 

971 

523 

448 

FLORIDA  STATE  BOARD   OF   HEALTH 


135 


BUREAU  OF  VITAL  STATISTICS 

DISEASES  OF  EARLY  INFANCY 

This  group  ranks  eighth  in  Florida  for  1929.  It  is  also  inter- 
esting to  note  that  the  total  deaths  from  this  group  last  year  was  lower 
than  for  any  year  during  the  past  five.  While  this  decrease  holds 
good  for  the  white  population,  it  is  not  so  for  the  colored  since  there 
were  twelve  more  deaths  from  this  group  charged  to  colored  popula- 
tion than  for  the  previous  year.  The  following  table  indicates  the 
number  of  deaths  from  this  group  for  the  past  five  years,  by  color. 


Year 

Total 

White 

Colored 

1929 

823 

501 

322 

1928 

853 

543 

310 

1927 

955 

624 

331 

1926 

1049 

671 

378 

1925 

885 

563 

322 

AUTOMOBILE  ACCIDENTS 

This  cause  ranks  ninth  in  Florida  and  there  is  so  much  to  give  in 
the  way  of  comment  on  this  particular  cause  that  it  would  possibly  be 
wise  not  to  make  an  attempt  at  discussion  at  all.  At  a  later  date, 
considerable  space  will  be  devoted  to  automobile  accidents  in  this 
publication  and  comment  mil,  therefore,  be  reserved  for  that  time. 
Deaths  from  this  cause  for  the  past  five  years  are  listed  below,  by 
color. 


Year 

Total 

White 

Colored 

1929 

496 

392 

104 

1928 

397 

295 

102 

1927 

427 

323 

104 

1926 

512 

396 

116 

1925 

454 

346 

108 

MALARIA 

This  cause  ranks  tenth  among  the  greatest  killers  in  Florida  and 
since  it  is  more  or  less  restricted  to  specific  areas,  it  is  of  more  con- 
sequence than  some  other  causes.  The  tabulation  below  plainly  indi- 
cates the  trend  in  this  preventable  disease  and  accounts  for  its  inclu- 
sion in  the  program  of  the  state  health  officer. 


Year 

Total 

White 

Colored 

1929 

470 

1    259 

211 

1928 

388 

224 

164 

1927 

208 

92 

116 

1926 

223 

98 

125 

1925 

209 

112 

97 

136  HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


EVERY  DAY  OF  THE  YEAR  IN  FLORIDA 


ore  often  than  not  a  life  preserver 
has  the  shape  of  a  fishing  rod, a  golf 
club  or  a  saddle. 


©    A.P.H.A. 


This  Issue  Exceeds  12,000  Copies 


FL.ORlDA 


AtTHW)f 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY.    1892 

STATE  BOARD  OF  HEALTH 


Entered  11  Second   Clnaa   Matter,  October  27,   1921 
■t  the   Poatoffice  at  Jacksonville.    Florida,   Under   the  Act   of   Augtut    24,    1911 


JACKSONVILLE,  FLORIDA 

red    aa   Second    Clnaa    Matter.    October    27, 
t   Jacksonville,    Florida,    Under    the   Act    < 

This  Bulletin  wilt  be  sent  to  any  address  in  the  State  free  of  charge* 

Vol.22  SEPTEMBER,    1930  No.  9 


Edited    by 
STEWART  G.  THOMPSON,  D.P.H..  Member 

American   Medical   Editors'    and    Author*'   Ann. 


SPECIAL  ARTICLES 

TUBERCULOSIS— Brink 

BACTERIA   IN   MILK— Eaton 

ECONOMY    IN    HEALTH— Hanson 

PROGRAM    OF    ACTIVITIES— Blackly 

MOTOR    VEHICLE    ACCIDENTS— Tkompson 

SEWERAGE    AND    SEWAGE    DISPOSAL— F&by 

SEE  YOUR  DOCTOR  FOR  SPARE  PARTS— Cartoon 


HENRY  HANSON,  M.   D.,  STATE  HEALTH  OFFICER 


138 


FLORIDA   STATE   BOARD    OF   HEALTH 


BOARD   MEMBERS 


Chios     H.     Mann,     Pres. 
Jacksonvillc 


H.    Mason     Smith,    M 
Tampa 


t 


Win.    D+    Nobles.    M. 
Pensacola 


STATE   HEALTH    OFFICER 

Henry    Hanson.    M.    D. 


BUREAUS   AT  JACKSONVILLE 


Diagnostic    Laboratories.. 
■Vital   Statistics- 


Communicable    Diseases  . 
Engineering- 


Child    Hygiene   and    Public    Health    Nursing.. 
Accounting ... 


Crippled    Children.. 


DIRECTORS 

Paul   Eaton,    M.   D„    D.    R   H. 
Stev/ari  G.  Thompson,  D.   P.   H. 
F.    A.    Brink,    M.    6. 
Ellsworth   L.  Filby.  C,  E. 
Lucile    Spire    Blachiy.     M,     D. 
Screven    Dozier 
F.  L,   Fort,  M.  D. 


*55Q    Local    Registrar*     (County    list    furnished    on    request). 

'Registration   Inspector Anna    C    Emmons 

Drug    Store    Inspector. ^__ ^.^^ , , H-    R-    Monroe 


Jacksonville., 
Miami... 


Pens  a  col  a — 
Tallahassee-. 
Tampa , „ 


LABORATORIES 


Pear!   Griffith.    B.    E. 
E.   R.    Pa  well 
Jane   B.   Carrie.   B.   S. 
Elizabeth    Byrd,    B,    S. 
H.    D.   Venters,    B.    S. 


DeFuniak     Springs... 

J  a  ckson  v  i  ]  I  e _ 

Vera     R^a^K 

Tallahassee 

Tampa i 


MEDICAL    OFFICERS 


C.    W.    McDonald.    M.    D. 
B.  C.    Wilson,  M-    D, 
W.   A.   CUxton,   M.   D. 
H*   A.    McGure,    M.    D. 
A,    C.    Hambtin,    M,    D. 


Jacksonville^ 

Jacksonville ... 
M  iami 


Ocala 


Orlando 

Punta    Gorda. 

Tallahassee . 

Ta  mpa 


DISTRICT   SANITARY   OFFICERS 


V*  B,   LamDurcui,  C   E* 
Fred    A.    Safay 
George   B.    Reed 
C,    A,    Holloway 
Russell     Broughman 
G,    A,   Renney 

C.  N.  Hobbs 

D.  H.   Osbum 


Lake  City 
Arcadia- 


PUBUC  HEALTH   NURSES 


DeFuniak    Springs 

Eden.  R.   F.  D.   Jensen.. 
Lake    City 

Madia  on- 


Ruskii* 


Slarke.. 


Clio  McLaughlin,   R.  N. 
Jule    Graves,    R.    N. 
Nanus    Colby,    Ft.    N. 
Sarah    Ida    Richards,    R.    N. 
Frances   Hall.   R.    N. 
Thora  Roberts,   R.  N. 
Joyce  Ely.    R.  N. 
Mary   C.    Dodd,    R.    N. 


Jacksonville  . 


COUNTY   HEALTH   UNITS 

■    E.  C  5toy   (U.  S.   P.  H.  3.) 


FLORIDA  STATE   BOARD   OF  HEALTH  139 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

ECONOMY  AND  HEALTH 

I  have  attended  two  meetings  of  the  Florida  League  of  Munici- 
palities and  on  each  occasion  endeavored  to  learn  of  what  had  trans- 
pired during  the  years  of  my  absence  from  Florida. 

At  the  meetings,  one  hears  papers  on  a  variety  of  topics  having 
to  do  with  municipal  administration.  Delegates  read  and  listen  to 
papers  in  a  calm  and  dignified  manner  until  some  intrepid  crusader 
speaks  on  bonded  indebtedness,  tax  relief  or  the  lack  of  uniform  as- 
sessment of  property  throughout  the  State.  In  this  he  shows,  while  he 
is  enthusiastically  reading,  that  some  are  over-taxed,  while  others  are 
assessed  on  a  basis  of  1  / 1  0  of  what  the  case  should  be.  He  and  others 
who  follow  his  lead  show  that  those  who  adopted  the  assessment  and 
taxation  system  went  Heinz  ten  better.  Florida  has  sixty-seven  stand- 
ards of  assessment  and  taxation.  As  for  collection,  the  Heinz  system 
appears  to  be  a  little  more  closely  followed  in  that  certain  taxes  can 
go  through  a  pickling  or  preserving  process  and  when  taken  up  after 
a  few  years  the  shrinkage  has  molded  them  to  a  size  more  convenient 
to  handle.  His  reasoning  is  plausible  and  gives  him  a  feeling  of  peace- 
ful content  until  he  looks  up  and  meets  glances  which  say  "thumbs 
down,"  and  then  the  sensations  along  his  spinal  column  are  not  so 
warm  and  he  loses  confidence  as  the  pandemonium  of  argument  breaks 
loose,  pro  and  con. 

Amidst  and  at  the  end  of  the  tumult,  there  appears  an  illustra- 
tion of  what  some  consider  those  'who  "enter  where  Angels  fear  to 
tread,"  who  tell  the  group  of  hoary-headed,  municipal  administrators 
that  they  have  all  been  cut  in  the  rain,  and  that  the  solution  is  some- 
thing besides  rain  water  and  not  the  one  so  eloquently  presented,  and 
vigorously  discussed;  viz,    that  they  all  have  hookworms. 

"Economy"  has  become  a  slogan  and  it  is  time  that  it  should 
be  so.  It  is,  however,  as  difficult  to  economize  wisely  as  it  is  to  spend 
wisely  and  one  must  be  careful  not  to  let  false  economy  lead  to  in- 
jurious retrenchments. 

A  state  or  municipal  health  department  is  an  insurance  policy 
as  essential  as  insurance  is  to  any  project  or  individual  needing  pro- 
tection. A  policy  taken  at  an  early  age  carries  a  lower  premium  if 
tontinued  than  the  same  policy  would  were  it  dropped  and  a  renewal 
attempted  at  a  later  date  when  the  premium  would  he  higher  due  to 
the  intervening  unprotected  time.  If  trouble  comes  in  the  form  of 
sickness  or  death  while  the  policy  is  ineffective  all  the  previous  in- 
vestment is  lost. 

The  Metropolitan  Life  Insurance  Company's  health  campaign 
"ver  a  period  of  seventeen  years  cost  the  company  $2"0, 000,000. 00, 
1  he  benefits  derived   from   the  investment  according  to    Dr.    Dublin, 


140  FLORIDA   STATE  BOARD   OF   HEALTH 

ADMINISTRATION 

in  savings  to  the  company  represented  by  less  sickness  and  fewer 
deaths  among  the  policy  holders,  were  $43,000,000.00  or  a  net  sav- 
ing of  $23,000,000.00.  This  viewed  from  a  purely  economic  basis 
is  a  saving  of  over  100%.  Investments  of  this  type  represent  good 
economy.  This  company  is  putting  more  money  into  its  health  cam- 
paign every  year  and  getting  increasing  returns. 

In  Florida,  every  citizen  who  pays  taxes  on  $1,000.00  pays  50c 
to  the  support  of  the  state  health  department,  the  State  Board  of 
Health.  In  the  larger  cities,  this  is  scarcely  the  price  of  one  good 
"movie"  picture.  If  each  such  citizen  would  invest  25c  more  for 
each  thousand  dollars  of  his  assessed  valuation  it  would  give  the  State 
Board  of  Health  sufficient  funds  to  provide  the  necessary  facilities 
to  carry  on  effective  health  protection  to  the  people  of  the  State,  es- 
pecially in  the  rural  communities  where  such  diseases  as  malaria  and 
hookworm  are  costing  the  state  over  $1,000,000.00  each  year,  or 
more  than  three  times  the  present  total  annual  resources  of  the  State 
Board  of  Health.  Bear  in  mind  that  this  loss  is  from  only  two  pre- 
ventable diseases.  There  are  several  other  causes  such  as  tuberculo- 
sis, maternal  and  infant  mortality,  pellagra,  etc.  What  is  the  logical 
economic  procedure? 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

Lucile  Spire  Blachly,  M.  D.,  Director 

PROGRAM    OF    ACTIVITIES 

August  3 1  marked  the  close  of  the  old  program  of  the  Bureau 
of  Child  Hygiene  and  Public  Health  Nursing  and  September  1  the 
beginning  of  the  new.  The  principles  underlying  the  new  will  be  quite 
the  opposite  in  some  respects  from  the  old.  In  the  old  program, 
much  of  the  time  of  the  state  nurse  was  spent  in  inspecting  children, 
white  and  colored,  in  the  one  and  two  teacher  schools,  in  inspecting 
infants  and  pre-school  children  and  in  the  instruction  and  examining 
of  midwives. 

In  the  new  program,  the  state  nurses  will  not  inspect  children, 
either  white  or  colored,  infant,  pre-school  or  school.  This  departure, 
we  realize,  will  be  regretted  by  those  who  have  come  to  look  upon 
these  inspections  as  an  end  in  themselves — some  maneuver  that  should 
be  done  annually  as  a  matter  of  custom — but  to  the  informed  the 
change  will  be  hailed  with  delight.  By  freeing  the  nurse  from  these 
time-consuming,  all  but  worthless  activities,  she  'will  be  able  to  attack 
preventable  disease  at  its  source,  i.  e.,  the  home.  In  the  new  program, 
the  major  part  of  her  time  will  be  spent  in  educating  the  parents  in 
the  prevention  of  disease  and  in  the  necessity  for,  and  the  methods 
of,  getting  physical  defects  and  ill  health  corrected.  Her  subject- 
matter  will  pertain   to   the  hygiene  of  maternity    and     infancy    and 


FLORIDA  STATE  BOARD  OF  HEALTH 14£ 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

the  pre-school  child  as  well  as  the  school  child  and,  when  indi- 
cated, his  parents.  Much  attention  will  be  given  to  nutrition  and  to 
health  habits.  The  home  care  of  the  sick,  particularly  those  suffering 
from  tuberculosis  and  the  communicable  diseases,  will  receive  atten- 
tion with  special  stress  on  methods  of  prevention.  Attention  will  be 
given  to  hookworm  control  and   to   mosquito-proofing  the  home. 

The  Director  of  the  Bureau  will  divide  her  time  between  dem- 
onstrations, child  health  conferences  for  infants  and  pre-school  chil- 
dren, the  preparation  and  distribution  of  literature,  maternity  letters, 
etc.,  talks,  and  executive  duties.  The  ideal  toward  which  she  is  work- 
ing is  two-fold;  (a)  the  adequate  supervision  and  guidance  of  every 
infant  and  pre-school  child  by  the  family  physician  or  pediatrician, 
and  (b)  the  adequate  supervision  and  guidance  of  every  expectant, 
parturient,  and  nursing  mother  by  the  family  physician  or  obstetri- 
cian. The  Bureau  will  at  all  times  seek  to  promote  a  close  spirit  of 
cooperation  between  patient  and  physician  as  being  necessary  to  attain 
these  ends.  Babies  come  in  single  packages  and,  therefore,  cannot  be 
handled  adequately  on  the  mass  production,  mechanical  basts.  The 
private  practice  of  medicine  must  be  retained  and  improved. 

The  methods  followed  will  vary  as  the  population  and  the  dis- 
tribution of  the  population,  facilities  for  the  prevention  and  treatment 
of  disease,  and  the  nature  of  the  public  health  problems  vary  but  each 
county  will  be  reached  during  the  fiscal  year.  Briefly,  the  nurses  will 
be  districted  as  at  present  and  each  nurse  visited  by  the  director  in 
rotation  as  rapidly  as  her  time  and  the  preliminary  work  of  the  nurse 
permits.  A  Child  Hygiene  Week  will  follow  the  social  assets  survey 
made  by  the  nurse  and  the  planning  committee.  The  major  activi- 
ties during  this  week  will  be  a  demonstration  child  health  conference, 
a  health  institute  for  community  leaders,  numerous  exhibits,  talks, 
lectures  and  demonstrations.  The  whole-hearted  and  active  coopera- 
tion of  all  existing  agencies,  county-wide  in  scope,  will  be  sought.  Fol- 
lowing the  Child  Hygiene  Week,  the  nurse  will  remain  in  the  county 
to  give  similar  talks,  exhibits  and  demonstrations  to  groups,  classes, 
schools  and  individuals.  The  work  done  in  any  county  by  the  Bur- 
eau of  Child  Hygiene  and  Public  Health  Nursing  will  be  in  the  nature 
of  a  sample  of  what  can  be  done  in  such  a  county  if  adequately  staffed 
by  a  full-time  county  health  unit. 


The  Bureau  of  Child  Hygiene  and  Public  Health  Nursing  has  two 
sets  of  letters  for  the  expectant  mothers  of  Florida,  one  set  for  those 
who  intend  using  a  midwife  for  the  delivery,  the  other  for  those  who 
intend  using  a  physician.  If  the  reader  desires  these  letters  for  her- 
self, some  member  of  the  family,  some  friend  or  neighbor,  write  to 
Bureau  of  Child  Hygiene  and  Public  Health  Nursing,  State  Board  of 
Health,   Jacksonville,  Fla. 


142  FLORIDA   STATE   BOARD   OF   HEALTH 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 
Paul  Eaton,  M.  D.,  D.  P.  H.,  Director 

BACTERIA  IN  MILK 

Two  dairymen  were  "talking  shop"  recently  and  one  said:  "This 
laboratory  stuff  is  the  hunk.  I  figure  that  they  thought  1  didn't  have 
a  clean  collar  on  last  week  when  1  milked  so  they  gave  me  a  count 
of  1,900,000.     Nobody  can  count  that  many  bacteria." 

He  was  wrong  about  the  collar,  but  he  was  right  about  counting 
1,900,000  bacteria.      Nobody  would  count  so  many  even  if  he  could. 

The  bacterial  count  of  milk  is  very  poorly  understood  by  many 
people  beside  the  dairyman  above  quoted.  There  are  practically  al- 
ways bacteria  in  milk  but  different  samples  of  milk  differ  so  widely 
in  this  respect  that  it  is  necessary  for  the  laboratory  to  have  some 
standard  way  of  expressing  the  bacterial  content  of  the  sample  in  ques- 
tion and  this  is  the  way  it  is  done. 

One  cubic  centimeter  of  the  milk  (about  a  quarter  of  a  teaspoon- 
ful)  is  very  carefully  measured  out  and  put  into  a  bottle  which  has 
in  it  99  c.  c.  of  sterile  water.  This  is  then  corked  'with  a  sterile  stopper 
and   shaken    twenty- five    times. 

Out  of  this  mixture  of  water  and  milk,  one  cubic  centimeter  is 
measured  into  another  99  c.  c,  of  sterile  water  and  thoroughly  shaken. 
These  bottles  are  labeled  "1-100"  and  "1-10,000"  because  in  the  first 
bottle  each  c.  c.  contains  1-100  part  of  the  original  c.  c.  of  milk  and 
in  the  second  bottle  each  c.  c.  contains   1-10,000  of  the  original  c.  c. 

Then  one  c.  c.  from  each  bottle  is  added  to  a  mixture  of  sea- 
weed jelly  and  beef  broth  that  will  give  each  bacterium  that  is  present 
a  chance  to  grow,  and  poured  into  a  sterile  glass  dish  which  is  put 
into  the  incubator  for  24  or  48  hours. 

If  there  were  1,000  living  bacteria  in  the  original  sample  of  one 
c.  c,  the  chances  are  that  one  one-hundredth  of  them  would  be  contain- 
ed in  the  1  c.  c.  sample  taken  out  of  the  first  bottle  for  cultivation.  This 
will  not  be  true  every  time,  because  chance  distribution  does  not  work 
that  way,  (as  anybody  who  has  ever  played  cards  knows)  but  in  the 
long  run,  it  evens  itself  up  and  at  any  rate  it  is  the  best  we  can  do. 

If  there  were  100,000  living  bacteria  in  the  original  sample  of 
1  c.  c.  the  first  plate  would  be  likely  to  have  1,000  colonies  which 
would  make  them  entirely  too  numerous  to  grow.  But  the  second 
plate  would  likely  have  about  ten  colonies. 

In  the  case  referred  to  at  the  beginning  of  this  article  there  must 
have  been   1 90  colonies  on  the  second  plate. 

The  best  proof  that  the  laboratory  methods  are  reliable  is  the 
fact  that  the  careful  dairyman  is  able  to  produce  milk  which  gives  uni- 


FLORIDA   STATE   BOARD   OF   HEALTH 


U3 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 

form  and  consistent  counts.  If  milk  is  thoroughly  and  quickly  chilled 
after  being  drawn  from  the  cow  and  is  kept  cool  it  will  usually  have 
a  count  below  25,000.  Sometimes  a  good  dairyman  will  have  an  ac- 
cident that  will  give  him  a  high  count.  Sometimes  a  poor  dairyman 
will  accidentally  produce  milk  with  a  low  count. 

No  one  count  ought  to  be  taken  as  an  index  of  the  care  and  skill 
of  a  dairyman  but  these  qualities  will  show  very  plainly  in  the  long 

run. 

SUMMARY    OF    WORK— JULY,   1930 

Jacksonville      Tampa      Pen&acola      Miami      Tallahassee      Total 

Animal   Parasites   930  392  31  431  18  1802 

Diphtheria     269  132  5  90  1  497 

Typhoid _ -'.  510  226  96  85  38  955 

Malaria    - 845  246  95  15  77  1278 

Rabies    16  2  4  22 

Tuberculosis    202  85  17  51  6  36f 

Gonorrhea      445  198  40  99  13  797 

Kahn      _ - 3911  1038  799  5748 

Water:  Count     46  136  1  1 83 

Water:  Colon    136  1  137 

Milk:  Bacterial  Exam  „.  96  274  94  338  23  825 

Milk:  Chemical  Exam.  141  260  95  480  23  999 

Miscellaneous      174  79  11  429  2  695 

7539     2978       484     3093        205    14299 
SPECIMEN  CONTAINERS  DISTRIBUTED  5752 


BIOLOGICAL  PRODUCTS  DISTRIBUTED 


Diphtheria  Antitoxin 1  0,000   units 

5,000   units 

Toxin  Antitoxin 

Schick _ „ - - 

Tetanus  Antitoxin „...„_ 


23,000   units 
10,000    units 
1,500  units 


Typhoid  Vaccine 

Vaccine  Virus 

Antirabic  Virus 

Carbon  Tetrachloride.. 


17 

6 

1169 

400 

10 

16 
1262 
2733 
1329 

29 
2273 


Packages 

Packages 

C.  C. 

Tests 

Packages 

Packages 

Packages 

Treatments 

Capillaries 

Treatments 

Capsules 


ALL  REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 

THE  STATE  LABORATORY,  STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 


144 FLORIDA  STATE  BOARD   OF  HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

FLORIDA  AND  TUBERCULOSIS* 

It  would  seem  that  the  time  has  come  to  dispel  certain  illusions 
and  correct  some  mistaken  ideas  regarding  tuberculosis  and  the  suit- 
ability of  Florida  climate  for  the  improvement  and  arrest  of  this  dis- 
ease. 

For  years,  there  has  been  a  belief  that  as  soon  as  a  person  de- 
velops tuberculosis  he  must  hasten  to  a  different  climate.  This  belief 
has  been  propagated  to  a  great  extent  by  those  interested  in  tubercu- 
losis centers  in  various  parts  of  the  country.  Circulars  and  literature 
are  sent  by  Chambers  of  Commerce  and  sanatorium  owners  extolling 
the  virtues  of  their  climate  and  altitude,  the  dryness  of  the  air,  the 
sunshine  and  other  features,  all  over  the  United  States.  However, 
the  opinion  is  fast  becoming  established  that  going  away  from  home 
to  take  the  "cure"  for  tuberculosis  is  an  expensive  and  unnecessary 
step.  This  has  resulted  in  many  sanatoria  in  so-called  tuberculosis 
centres  having  only  one-fourth  as  many  patients  as  a  few  years  ago. 
Sanatoria  in  every  state  are  arresting  tuberculosis  without  sending  pa- 
tients away. 

The  death  rate  from  tuberculosis  in  Florida  in  1 928  was  only 
half  of  one  per  cent  more  than  that  of  the  whole  United  States,  al- 
though a  considerable  portion  of  the  population  is  negroes  whose 
tuberculosis  death  rate  is  higher  than  that  of  the  whites. 

Let  us  attempt  to  evaluate  our  Florida  climate  and  learn  some 
of  its  advantages.  First,  let  us  consider  "fresh  air."  There  is  no  time 
of  year  when  outdoor  air  cannot  be  tolerated  twenty-four  hours  of 
the  day.  In  northern  climates,  patients  sleep  on  porches  in  zero  weath- 
er and  like  it.  Florida  atmosphere  besides  being  "fresh  air"  in  the 
generally  accepted  sense  is  also  "pure  air."  When  we  realize  that  in 
the  north  everyone  who  comes  in  contact  with  a  tuberculosis  patient 
is  passing  him  disease  germs  which  give  him  colds,  influenza  or  pneu- 
monia and  that  even  in  the  best  regulated  households  in  the  north 
some  person  or  other  near  him  has  a  cold  more  than  half  the  time, 
we  can  see  the  advantages  of  our  pure  circulating  air. 

Now  take  the  matter  of  dust.  Florida  has  less  dust  than  states 
with  wind-swept  prairies  and  deserts,  few  dusty  roads,  less  pollen-laden 
breezes  tf^at .generate  hay  fever  and  asthma.  Experiments  carried  out 
recently  under  the  direction  of  the  National  Weather  Bureau  show 
that  pollen  from  ragweed  which  causes  85  %  of  the  hay  fever  in  the 
United  States  is  practically  absent  in  Florida's  atmosphere. 


*Prepared  on  request  by  Dr.  W.  A.  Claxton,  Field  Medical  Officer. 


FLORIDA  STATE   BOARD  OF  HEALTH 145 

BUREAU   OF   COMMUNICABLE   DISEASES 

""^  In  many  northern  cities  and  even  in  small  towns,  the  air  in  winter 
is  laden  with  coal  dust.  One  cannot  fully  realize  this  except  by  ex- 
perience. 

Florida's  sunshine  has  been  praised  over  and  over  again  and  not 
without  justification.  The  health-giving  rays  are  always  with  us.  An 
abundance  of  fresh  vegetables  and  fruit  is  always  at  our  door  to  give 
us  a  balanced  diet. 

With  all  these  natural  advantages  to  which  we  must  add  that  of 
a  comfortable  temperature,  we  must  still  consider  the  great  factor  of 
rest  in  the  care  of  tuberculosis.  Persons  with  this  disease  should  place 
themselves  under  the  care  of  a  good  physician  who  can  direct  their  ex- 
ercise and  minister  to  those  minor  ailments  which  appear  from  time 
to  time.  He  can  tell  them  when  they  should  be  in  bed  and  ■when 
they  should  be  up;  whether  they  should  take  15  minutes  a  day  exer- 
cise or  two  hours  a  day. 

The  treatment  of  tuberculosis  depends  on  a  routine  of  living  more 
than  on  the  administration  of  drugs.  No  medicine  or  serum  has  been 
discovered  that  will  cure  tuberculosis. 

DOCTORS  ARE  HONEST 

To  reach  the  pinnacle  of  professional  success  in  his  profession, 
it  is  essential  that  a  doctor  be  honest  with  himself  and  that  usually 
makes  him  honest  with  others.  He  is  taught  truths  at  college,  he  seeks 
the  truth  from  his  patients  in  order  that  he  may  render  them  maximum 
service,  and  square  dealing  comes  to  be  habitual.  But  why  dwell  on 
that?  A  few  doctors,  thinking  to  protect  their  patients  or  benefit 
the  community  or  just  from  press  of  work  or  carelessness,  may  really 
do  harm  by  failing  to  make  accurate  reports  of  communicable  diseases 
and  the  causes  of  death.  Is  it  more  important  to  avoid  some  tem- 
porary reproach  for  having  in  the  community  a  preventable  disease 
or  to  admit  its  presence,  face  the  issue,  fight  the  cause  of  disease  and 
avoid  a  harsher  and  merited  reproach  because  of  sickness  and  the  loss 
of  life   which  could  have  been  averted? 

THE  LOVE  APPLE 

There  are  people  living  today  -who  well  remember  the  time  when 
tomatoes  were  called  "love  apples."  They  were  said  to  be  poisonous 
and  were  not  used  for  food.  Their  importance  in  the  daily  diet  of 
man  depends  on  the  vitamines  they  contain.  Everyone  should  con- 
sume some  fresh  or  canned  tomatoes  regularly.  They  are  beneficial 
to  all  ages. 

REMEMBER 

Diphtheria  is  most  deadly  to  pre-school  children.  Get  your  doc- 
'or  to  immunize  them. 


146 FLORIDA   STATE   BOARD   OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

WHY  THE  DEMONSTRATIONS? 

One  big  objective  of  the  State  Board  of  Health  is  health  educa- 
tion. 

Malaria  costs  money. 

Malaria  can  be  prevented  by  avoiding  mosquitoes. 

The  mosquito-proof  home  is  the  best  protection. 

Hookworm  disease  is  expensive.  It  delays  the  progress  of  its 
victims.  More  groceries  must  be  purchased  to  raise  a  child  to  the 
point  of  productiveness  if  he  has  hookworms. 

A  sanitary  privy,  used  by  all  members  of  the  household  prevents 
soil  contamination  of  hookworm  disease. 

Now  the  demonstrations  are  to  demonstrate  how  to  mosquito- 
proof  the  average,  cheaply  constructed,  rural  home  and  how  to  build 
a  sanitary  privy.      That  is  health  education. 

The  demonstrations  are  not  for  the  benefit  of  the  single  family 
living  on  the  premises,  though  the  family  is  greatly  benefited.  Those 
premises  are,  according  to  agreement,  open  for  inspection  at  all  rea- 
sonable hours.  Great  interest  has  been  shown  in  some  places,  in  other 
places  none.  We  are  disappointed  if  the  response  of  the  community 
suggests  indifference  to  these  important  health  problems.  It  makes 
us  wonder  if  we  have   failed   to  present   the  matter  in   its  true  light. 

We  hope  that  many  wives  will  slip  around  and  look  the  job  over, 
then  go  home  and  tell  their  husbands  about  all  the  comforts  and  pro- 
tection the  neighbors  are  enjoying.  Then  we  hope  friend  husband 
will  take  a  day  off  and  fix  up  the  place.  News  of  such  doings  would 
cheer  us  on  greatly  in  our  work. 


BELIEVE  IT  OR  NOT 

Measles  and  whooping  cough  are  particularly  deadly  to  young 
children.     They  should  not  be  exposed. 

Of  the  sixteen  persons  who  died  of  diphtheria  during  the  first 
four  months  of  this  year,  twelve  were  under  five  years  of  age.  Toxin- 
antitoxin  would  have  saved  them.  It  should  be  given  by  the  family 
doctor  at  age  six  to  twelve  months.      See  your  own  doctor. 

Hookworm  disease  results  from  contamination  of  the  soil  with 
human  excrement.  A  sanitary  privy,  used  by  everyone,  will  prevent 
hookworm.  Ask  the  State  Board  of  Health  for  hookworm  and  privy 
bulletins. 


FLORIDA  STATE  BOARD   OF   HEALTH 147 

BUREAU    OF    COMMUNICABLE    DISEASES 

EVENTUALLY  SMALLPOX  WILL  RETURN 

The  periodical  outbreak  of  smallpox  is  due  to  a  gradually  increas- 
ed percentage  of  non-immunes.  When  there  are  enough  of  these  in 
any  section,  then  the  first  imported  case  acts  like  a  spark  in  a  tinder 
box — it  starts  things. 

Those  who  have  smallpox  are  the  ones  "who  have  put  off  getting 
vaccinated  until  too  late.  Better  ask  the  doctor  to  vaccinate  you  tmd 
the  children.  That  is  better  even  than  to  wait  for  the  Board  of  Health 
doctor  to  come  around. 

BUREAU  OF  ENGINEERING 
E.  L.  FUby,  C.  E,,  Chief  Engineer 

SEWERAGE    AND    SEWAGE    DISPOSAL    IN    FLORIDA— 1930 

(Continued  from  August) 

At  Key  West,  our  island  city,  there  are  no  public  sewers.  A  few- 
private  sewers  exist  but  individual  tanks  are  used  if  flush  type  toilets 
are  installed.  The  tack  of  a  public  water  supply  prevents  the  instal- 
lation of  a  modern  sanitary  sewer  system.  Salt  water  or  brackish 
water  from  shallow  wells  in  the  rock  is  often  used  for  toilet  purposes. 

Over  on  the  West  Coast  we  find  flat  topography,  sandy  soil  and 
many  long  reaches  of  brackish  water  extending  inland  from  the  gulf. 
So  we  have  the  cities  utilizing  many  outfalls  into  the  river  waters.  Ft. 
Myers  undertook  an  extensive  sewerage  program  and  built  a  lot  of 
sanitary  sewers  in  undeveloped  subdivisions.  Money  ran  out  and  a 
collecting  outfall  line  was  abandoned.  The  treatment  plant  was  about 
one-third  built  and  since  has  been  abandoned.  It  was  to  be  of  the 
separate  sludge  digestion  type  but  excessive  infiltration  and  high  pump- 
ing charges  have  led  to  by  passing  and  practical  abandoning  of  the 
plant  at  Billy's  Creek.  The  group  of  cities  on  the  Manatee  River. 
Bradenton.  Palmetto,  Manatee  and  Ellenton,  all  utilize  dilution  of  raw 
sewage  and  partial  treatment  in  septic  tanks.  Tampa,  the  largest  city 
on  the  West  Coast,  uses  Imhoff  tank  treatment  for  a  portion  of  its 
sewage  but  a  large  portion  of  the  sewage  goes  into  the  Hillsborough 
River,  raw.  The  Imhoff  tank  installations  are  overloaded  and  are  a 
source  of  odor  nuisance  as  the  sludge  is  only  partially  digested. 

St,  Petersburg,  the  sunshine  city,  has  a  modern  mechanical  coarse 
and  fine  screen  plant  followed  by  chlorination.  However,  as  the 
chlorination  is  not  controlled  by  Ortho-tolidme,  it  is  not  continuous  or 
effective.  The  ultimate  disposal  is  into  the  bay  through  a  long  out- 
fall. Clearwater  uses  a  large  septic  tank  installation  and  many  small 
°nes.  Chlorination  of  the  raw  sewage  before  tank  treatment  was 
utilized  to  prevent  odor  nuisance.  Perry,  up  in  our  lumber  region, 
deposes  of  its  sewage  raw  into  a  creek  near  town. 


146 FLORIDA   STATE   BOARD   OF   HEALTH 

BUREAU  OF  ENGINEERING 

In  the  northeastern  portion  of  our  state,  we  have  the  St.  Johns 
River  system  of  large  lakes.  All  cities  on  the  river  use  dilution  with 
or  without  tank  treatment,  first.  Sanford  and  Green  Cove  Springs 
use  the  combined  system  of  sewers. 

In  the  central  part  of  Florida,  we  have  a  ridge  section  of  sand 
hills  dotted  with  lakes  in  almost  every  depression.  Solution  channels 
have  so  dissolved  the  underlying  structure  of  limestone  that  many 
lakes  are  found  and  few  streams  on  the  surface.  Many  of  the  lakes 
are  connected  underground,  a  few  on  the  surface.  Thus,  we  have  such 
cities  as  Gainesville  discharging  into  a  large  lake  called  Paynes  Prairie 
and  the  University  of  Florida  at  Gainesville  using  Imhoff  tank,  sprink- 
ling filter  and  discharge  into  a  cavity  in  the  limestone.  Ocala,  a  city 
of  7-275  population,  brings  its  sewage  to  two  Imhoff  tank  installations 
and  disposes  of  the  effluent  following  roughing  filters  and  chlorination 
into  several  drainage  wells.  Williston  uses  a  septic  tank  and  seepage 
into  a  limestone  pit.  There  is  no  water  course  within  miles  of 
Williston,  likewise,  Ocala,  where  the  nearest  water  course  is  Silver 
Springs  run,  five  miles  distant. 

Orlando,  the  city  beautiful,  depends  upon  drainage  wells  entirely 
to  dispose  of  its  wastes.  All  storm  water  and  sanitary  sewage  are  dis- 
charged into  these  wells.  Numerous  lakes  and  ponds  dot  the  city  but 
the  sewage  is  run  through  small  septic  tanks  and  thence  into  these 
wells.  An  expensive  collection  and  pumping  program  must  face 
Orlando  for  the  time  will  come  when  the  sewage  wells  must  be  aban- 
doned. Wildwood,  likewise,  uses  a  drainage  well  for  sewage  disposal 
after  Imhoff  tank  treatment  and  chlorination.  Along  the  southern 
portion  of  the  ridge,  in  the  sand  hill  country,  we  have  Haines  City 
with  a  modern  plant  of  clarifiers,  separate  sludge  digestion  tanks  and 
natural  sand  filters.  At  Avon  Park  and  Sebring,  we  have  septic  tanks 
and  sand  filters  (natural).  Lake  Wales  utilizes  a  septic  tank  and  dilu- 
tion. At  Sebring,  it  is  interesting  to  note  that  the  sewage  discharged 
into  the  sand  beds  never  appears  at  the  end  of  the  under  drains.  At 
Winter  Haven,  popular  prejudice  against  pollution  of  a  lake  has 
thrown  out  of  use  a  sewerage  system  installed  some  six  years  ago  while 
another  system  discharges  after  septic  tank  treatment  into  a  large  lake 
without  nuisance.  A  sewage  well  installed  at  Winter  Haven  has  not 
been  used.  At  Lakeland,  we  have  partial  treatment  by  fine  screens, 
a  Dorr  clarifier  and  separate  sludge  digestion.  A  bad  mosquito  nuisance 
is  caused  by  the  effluent  as  it  discharges  into  a  drainage  canal.  Deple- 
tion of  the  oxygen  content  of  the  stream  prevents  fish  control  of  mos- 
quito production,  a  control  which  is  very  effective  upstream  and  some 
distance  down  stream. 

These  ridge  and  central  Florida  cities  have  had  a  rapid  growth 
but  many  still  depend  on  individual  septic  tanks  for  the  soil  is  very 
porous  and  will  absorb  large  quantities  of  liquid  wastes.  Houses  in 
these  cities  are  very  scattered  and  the  cost  of  sewers  is  ofttimes  pro- 
hibitive, especially  in  view  of  the  present  bonded  indebtedness  of 
these  cities. 

(Concluded  in  October) 


FLORIDA  STATE  BOARD   OF  HEALTH J49 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P,  H.,  Director 

KILLED  BY  MOTOR  VEHICLES 

During  the  calendar  year  1929,  there  were  496  per- 
sons in  Florida  killed  by  motor  vehicles.  Of  that  num- 
ber, 392  were  white,  and  1 04  colored. 

Duval  County  having,  according  to  the  census 
which  has  recently  been  taken,  the  greatest  population 
of  any  county  in  the  State,  naturally  leads  in  the  great- 
est number  of  persons  killed  from  this  cause,  having  68  deaths.  Dade 
County  was  a  close  second  with  65  and  Hillsboro  County  was  third 
with  a  total  of  4  1 . 

Accidents  caused  by  motor  vehicles  are  not  reportable  in  this 
state  but  we  might  draw  reasonable  deductions  as  to  our  own  figures 
by  comparison  with  information  contained  in  a  recent  issue  of  the 
New  York  "Health  News." 

"The  New  York  State  Bureau  of  Motor  Vehicles  reports  34,402 
people  injured  and  914  killed  in  motor  vehicle  accidents  during  the 
first  five  months  of  1930,  an  increase  of  72  deaths  over  the  corres- 
ponding period  in  1 929.  A  study  of  the  table  prepared  by  the  Bu- 
reau reveals  some  significant  facts. 

"It  is  evidently  safer  to  ride  than  walk,  for  out  of  the  total  of 
34.402  persons  injured  18,136  were  pedestrians  while  only  I  1,133 
were  hurt  in  collision  with  automobiles. 

"Of  the  number  of  accidents  involving  pedestrians  4. 1 98  were 
caused  to  persons  crossing  between  intersections,  4,054  to  children 
playing  in  the  street,  2,710  to  persons  crossing  intersections  against 
signals,  and  1,671  to  pedestrians  coming  from  behind  a  parked  car. 
These  facts  speak  for  themselves.  In  cities  the  pedestrian  is  more 
often  to  blame  for  injuries  received  than  the  automobile  driver. 

"The  greatest  number  of  accidents  (2,648)  occurred  between 
five  and  six  p.  m.  during  the  homeward  trend  of  travel;  the  next 
greatest  between  seven  and  eight  p.  m.  (2,606).  From  eight  to  nine 
p.  m.  (2,468)  and  from  six  to  nine  p.  m.  (2,450)  come  next  in  nu- 
merical frequency. 

"As  might  be  expected,  Sunday  was  the  day  on  which  most  acci- 
Hents  (5,762)  occurred  with  Saturday  a  close  second  (5,504).  The 
cither  days  of  the  week  vary  but  little,  Thursday  having  the  lowest 
-ecord,  4,297." 


150 


FLORIDA   STATE   BOARD   OF  HEALTH 


BUREAU  OF  VITAL  STATISTICS 

Deaths  from  Automobile  Accidents  in  Florida  by  Color  and  by 

Counties — 1 929. 


Counties 

Total 

White 

Colored 

0. 
I. 

2 

3. 
4. 
5. 

Sta  te  .„. . 

Alachua  - 

Baker    „ 

Bay  ,. 

Bradford  

Brevard 

496 
8 
2 
4 
4 
9 

392 

•5 
1 

4 
3 
8 

104 
3 

1 
.„„ 

1 

6 

Broward 

14 

i 

3 

10 

...... 

1 
3 

4 

7. 
5  5 

Calhoun „ 

Charlotte  

8. 

9. 

62. 

Citrus 

Collier  

1 

in, 

Columbia  , 

5 
65 

1 

68 
20 

5 

51 

1 

50 
16 

11. 
12. 
56. 

n 

Dade  „ 

DeSoto  

Dixie  „ „  

Duval   

14 

Is 

14. 

Escambia  „ — 

4 

53. 
15. 
16 

Flagler  „. 

Franklin 

Gadsden 

1 

1 
1 

6 
1 
1 
1 

1 

64. 
i7 

Gilchrist   - 

65. 

Gulf. 

— 

17. 
58. 
63. 
18. 
59. 
19. 

Hamilton  „    

Hardee „ 

Hendry _. 

Hernando 

Highlands  .. 

Hillsboro  

3 

...... 

4 

I 

41 

2 

3 

I 

39 

1 

"7 

"2 

70 

Holmes  „  .     „.. 

3 

3 
6 

2 
3 
6 

1 

66. 
21. 

Indian   Rivet  „ 

Jackson 

FLORIDA  STATE  BOARD  OF   HEALTH 


(51 


BUREAU  OF  VITAL  STATISTICS 

Deaths  from  Automobile  Accidents  in  Florida  by  Color  and  by 
Counties — 1929 — (Continued) 


Counties 

Total 

White 

Colored 

22. 

Jefferson 

Lafayette 

2 

-j 

5 
9 
3 

~9 
6 

15 
3 
1 

2 
3 

19 

2 
29 

7 
15 
17 
10 
11 

2 

3 
8 
5 
3 

2 

I 
15 

1 

1 

~4 
4 
5 
3 

~6 

3 

10 
3 

2 

2 

15 

2 
20 

6 
14 
14 

6 
11 

1 

3 

7 
5 
3 

1 

1 
12 

"3 

1 

24. 
?5 

Lake  _ 

In. 

3 

1 

?6 

1  ,^on 

4 

27. 

78 

Levy  

— 

29. 
30. 
31 

Madison  

Manatee 

Marion  - 

3 
3 
5 

67 

Martin  „ 

32. 

33. 
34. 
54. 
15 

Monroe  

Nassau 

Okaloosa  „,... 

Okeechobee    

Orange  

1 

i 
1 

36. 
37. 

38. 
39. 
40. 
41. 
4? 

Osceola  

Palm  Beach  - 

Pasco  — .—_. 

Pinellas 

Polk     

Putnam 

St.  Johns  ...  _ 

~9 

1 
1 
3 
4 

43. 

St    LtiHe                     ,,..,... 

1 

44. 
60. 
45. 
46. 
47 

Santa  Rosa  

Sarasota 

Seminole  .... 

Sumter _... 

"1 

48. 
61 

Taylor  - — 

— 

49. 
50. 
51 

Volusia   

Wakulla 
Walton 

3 

~7 

52. 

Washington    _. 

— 

152 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


SEE  YOUR  DOCTOR  FOR  SPARE  PARTS 


DIAGRAM  OF  A 
OBUCATE  MACMNE 
NEED/NG  FREQUENT 

mpEoxwoFms 

MD/CATED  IN  ORDER 

TO  OPERATE  AT  FUll 

EFF/CTFNCr. 

3EOWMNDA  TWi  M 

VALUES  vtftrtow. 


©  A.r.H.fc 


This  Issue  Exceeds   1  2,000  Copies 


(?LORIOA 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY,    1892 

STATE  BOARD  OF  HEALTH 


Entered    am    Second    Class    Matter,    October    27*    1921 
■  t   the    Poitoflice  at   Jacksonville,    Florida.   Under   the  Act    of    Augu.i    24.    1912 


JACKSONVILLE,  FLORIDA 

red    as    Second    Class    Matter,    October    27. 
t   JackionvllJe,    Florida.   Under   the  Act    t 

Thia  Bulletin  will  be  sent    to  any  address  in  the  State  free  of  charge, 

-Vol.22  OCTOBER,  1930  No.  10 


Edited    by 
STEWART  G.  THOMPSON.  D.P.H..  Member 

American   Medical   Editors'   and   Authors"   Ann. 


SPECIAL  ARTICLES 

KNOCKS  AND  BOOSTS— Hanson 

MILLIONS  FOR  DEFENSE— Brink 

HIGH  SCHOOL  MORTALITY— Thompson 

SEWERAGE  AND  SEWAGE  DISPOSAL— Filby 

A  HALLOWE'EN  TRIP  TO  THE  STARS— Cartoon 

PHYSICAL  EXAMINATION  BLANKS  for  TEACHERS— Blackly 


HENRY  HANSON.  M.  D-.  STATE  HEALTH  OFFICER 


154 


FLORIDA   STATE   BOARD    OF   HEALTH 


BOARD    MEMBERS 


Chas    H.    Mann.    Prea. 
Jacksonville 


H,    Mason     SmilJi.    M.     D. 
Tampa 


Wm.    D.    Noble*,    M.    D. 

Ptnsatola 


STATE   HEALTH    OFFICER 
Henry    Huiqd,    M.    D, 


BUREAUS   AT  JACKSONVILLE 


DIRECTORS 


Diagnostic    La  bo  rat  uric  a 

■Vital    Statistic*...... 

Communicable   D 
Engineering 


Paul    Eaton,    M.    D„    D,    P,    H. 

Stewart   G.   Thompson,   D,    P.    H. 

. —  F.  A,  Brink,  M.   D, 

„  Ellsworth    L.   Filby.   C.   E, 

Child  Hygiene  and  Public  Health   Nursing .__  Lucile   Spire    Blachly,    M.    D- 

Accounting Screven    Dozier 

Crippled    Children 1 F.   L.    Fort*   M.   D. 

"550     Local    Registrars     (County    list    furnished    on    request),  * 

"Registration   Inspector Anna   C    Emmons 

Dru ft    Store    Inspector i . i . , H.    R.    Monroe 


LABORATORIES 


g 


acksonvilie- 


Peneacola 


Tallahassee.. 
Tampa 


Pearl    Griffith.    B.    E- 
E.   R.    Powell 
Johnelie  McCormick 
Jntir    B.    Currie,    B.    S, 
H,    D.   Venters,    B.    5, 


MEDICAL   OFFICERS 


DeFuniiik    Springs- 

Ja  ckson  v  til  e_ 

Vero    Beach 

Tallahassee ^ 

Tampa... 


Brooksville- 


,  C    W.    McDonald,   M.    D. 

B.  C.    Wilson,   M.    D. 
W.    A,    Claxton,    M.    D, 
H,   A.    McClure,    M.   D. 

C.  W,  Pease,  M,  D. 
A.  C  Hamblin,  M.  D, 


Jackson  vi  tit. 
Jacksonville.., 

Miami 

Oca  1  a 

Orlando... 


DISTRICT  SANITARY    OFFICERS 


Punta    Gorda 

Tallahassee 

Tampa 


V,  B.  Lamoureux,  C  £. 
Fred    A,    Safay 
George   B.   Reed 
C.    A.    Holloway 
Russell     B  rough  man 
G.   A,   Renney 

C.  N.   Hobbs 

D.  H.    Ostium 


Lake  City  . 

Arcadia- 


PUBLIC  HEALTH   NURSES 


DeFuniok  Spring*- 
Eden,   R.    F.   D.   Jensen.. 
Lake    City 

M  a  di  son , 

Mariartna . 


Stnrke- 


Clio  McLaughlin,   R.   N. 
Jule    Craves.    R.     N. 
Nanna  Colby,  R.  N. 
Sarah    Ida    Richards,    R. 
Frances    Hall.    R.    N. 
Thora  Roberts,   R,  N. 
Lalla    Mary    Coggin».    R. 
Joyce  Ely.   R.   N. 
Mary   C.    Dodd.    R.   N. 


Jacksonville 


COUNTY  HEALTH   UNITS 

E.  C.   Stoy   <U.  S.   P.  H.  S.l 


FLORIDA  STATE   BOARD   OF  HEALTH [55 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

KNOCKS  AND  BOOSTS 

Whenever  a  new  enterprise  is  launched  it  is  met  with  "knocks  and 
boosts."  It  usually  depends  on  how  the  new  venture  appears  to  af- 
fect the  interests,  occupation,  or  finances  of  the  individual.  It  be- 
comes a  question  of  "politics"  and  each  person  has  to  decide  whether 
he  will  be  for  or  against.  It  is  doubtful  if  there  ever  was  a  project  of 
any  kind  which  received  universal  support  or  approval  when  first  made 
known  to  the  people. 

When,  a  few  months  ago,  the  State  Board  of  Health  began  to  take 
stock  of  the  actual  existing  health  conditions  in  the  State,  there  were 
outstanding  facts  which  at  first  glance  looked  serious.  As  these  were 
studied,  the  added  information  pointed  to  two,  three,  or  possibly 
four  or  five  factors  playing  a  big  part  in  the  retardation  of  progress 
in  the  rural  communities.  It  seems  that  the  farmer  has  been  most 
neglected  by  the  Health  Department  and  that  he  and  his  family  suffer 
more  from  preventable  sickness  than  people  in  any  other  walk  of  life 
in  the  S':ate  of  Florida.  It  is  not  right  that  it  should  be  so.  In  the 
pioneer  days  in  the  west,  the  farmer  was  an  object  lesson  in  health  and 
robustness.      He  can  and  soon  will  be  in  Florida, 

Usually  the  man  who  opposes  the  County  Health  Unit  plan  is 
one  who  has  not  taken  time  to  study  the  need  for  the  unit  and  is  labor- 
ing under  the  misapprehension  that  it  will  interfere  with  his  private 
income.  Other  objectors  are  those  who  are  always  opposed  to  any 
change.  We  will  soon  convince  the  reasonable  and  fair-minded  cit- 
izens of  the  practicability  and  correctness  of  our  program  in  bringing 
the  health  service  directly  in  through  the  farm  house  door,  and  then 
the  members  of  the  "anvil  chorus"  will  be  so  busy  shoeing  horses, 
making  and  sharpening  plow  shares,  etc.,  that  they  will  forget  what 
the  original  reason  for  knocking  was. 

The  boosters  are  among  those  who  wish  to  see  Florida  develop, 
and  are  willing  to  contribute  their  mite  to  this  end.  The  booster 
realizes  that  the  farmer  must  be  given  a  chance.  He  must  be  kept 
well  and  working  if  he  is  to  bring  forth  produce  both  in  variety  and 
quantity,  which  will  establish  markets  and  create  a  demand  for  Florida 
products.  If  the  farmer  is  kept  well,  he  will  get  out  of  debt  and  lay 
off  the  yoke  of  high  interest  rates.  It  would  be  better  for  the  state 
to  have  more  prosperous  farmers  and  fewer  finance  corporations. 

While  it  appears  very  probable  that  Florida  will  be  chosen  for 
the  Soldiers'  Home  on  account  of  its  climate  and  health-giving  sun  rays, 
there  are  areas  which  will  be  rejected  for  the  site  owing  to  a  high  in- 
cidence of  preventable  disease.  A  county  health  service  would  re- 
move such  objections. 


156  FLORIDA   STATE  BOARD   OF   HEALTH 


ADMINISTRATION 

The  program  has  received  knocks  on  the  grounds  of  increased 
taxation.  A  recent  calculation  by  a  leading  banker*  shows  that  the 
cost  of  preventable  sickness  in  the  State  is  equal  to  a  30  mill  tax.  or 
an  equivalent  of  $30.00  on  every  $1,000.00  of  assessed  valuation. 
At  the  present  time,  each  individual  who  pays  taxes  on  an  assessment 
of  $1,000.00,  pays  fifty  cents  a  year  toward  the  support  of  the  State 
Board  of  Health  and  this  is  not  enough  to  extend  sufficient  health  ser- 
vice to  the  farmer.  Some  counties  can  put  in  a  service  for  1/10  of  a  mill 
(others  will  need  1,  I  Yl  or  2  mills)  which  means  that  the  person  pay- 
ing taxes  on  $1,000.00  assessed  valuation  pays  ten  cents  a  year  addi- 
tional to  provide  for  the  County  Unit.  There  would  be  no  hesitation 
if  this  were  proposed  for  hogs  and  some  would  enthuse  over  the  idea 
if  it  were  for  poodles,  Pekingese,  or  dogs  in  general,  but  since  it  is 
only  for  babies  and  children  it  seems  ridiculous  to  become  so  senti- 
mentally extravagant  in  a  health  program.  Ten  cents,  fifty  cents, 
one  dollar,  five  dollars,  ten  dollars  a  year  are  about  the  average 
amounts  as  they  "would  affect  different  classes  and  individuals.  Bankers 
and  business  men  wager  and  lose  as  much  or  more  every  time  they 
play  a  game  of  golf. 

By  a  cooperative  arrangement  with  the  Federal  Health  Service, 
we  are  able  to  offer  one-third  to  one-half  of  the  cost  of  the  health  unit 
from  outside  sources,  and  the  county  is  only  spending  fifty  to  sixty-six 
cents  to  get  a  dollar. 


*Mr.   Chas.    H.    Mann,   President  of  the  State   Board  of  Health. 


SWIMMING  REDUCES  CHILDREN'S  WEIGHT 

Children  tend  to  gain  weight  during  the  school  year  and  to  lose 
it  during  the  summer,  at  least  on  the  Pacific  Coast,  according  to  a 
study  made  in  the  public  schools  of  Seattle  described  in  the  October 
Hygeia.  Measurements  of  height  and  weight  taken  in  the  spring  over 
a  four-year  period  showed  fewer  underweight  children  than  those 
taken  in  the  fall. 

The  tendency  to  lo3e  weight  in  the  summer  was  strikingly  shown 
in  one  school  located  on  a  point  of  land  in  Puget  Sound.  The  shore 
is  one  continuous  bathing  beach  and  swimming  in  the  cold  waters  of 
the  Sound  is  the  favorite  summer  sport.  Since  swimming  in  cold  water 
is  not  conducive  to  putting  on  weight,  the  children  of  this  school 
showed  a  wide  variation  in  weight  between  their  spring  and  fall  mea- 
surements. 


FLORIDA   STATE  BOARD   OF  HEALTH 157 

BUREAU  OF  ENGINEERING 

E.  L.  Filby,  C.  £.,  Chief  Engineer 

SEWERAGE  AND  SEWAGE  DISPOSAL  IN  FLORIDA  —   1930 

(Concluded) 

Cities  are  gradually  awakening  to  their  sewerage  and  sewage  dis- 
posal problems  and  now  that  the  so-called  frills  of  municipal  develop- 
ment, such  as  civic  centers,  golf  courses,  subdivision  pavement,  etc., 
are  no  more,  we  can  expect  progress  along  the  lines  of  sewage  disposal. 
In  fact,  the  tendency  has  been  to  divert  funds  received  from  the  sale 
of  utilities  to  sewage  treatment.  No  Florida  city  is  utilizing  a  sewer 
service  charge  as  no  permissive  bill  has  been  passed  by  the  legislature 
allowing  such  a  levy.  It  is  needed  and  will  be  introduced  in  the  1  93  1 
legislature  as  a  State  Board  of  Health  measure. 

There  are  no  sanitary  (sewerage)  districts  in  Florida  although 
there  is  a  law  authorizing  one  for  the  vicinity  of  Tampa.  The  State 
Board  of  Health  has  been  active  in  trying  to  organize  a  district  there 
to  relieve  the  serious  nuisance  caused  by  the  abandonment  and  non- 
maintenance  of  sanitary  sewers  built  by  subdividers  in  1924-25-26. 
These  systems  were  not  carefully  designed  and  were  hastily  built  and 
now  that  the  area  is  thickly  settled,  they  are  overloaded  and  going  to 
pieces  rapidly.  The  State  Board  of  Health  is  without  power  to  order 
the  county  commissioners  to  take  steps  to  create  the  district  and  as  the 
area  in  question  is  now  in  the  courts  seeking  relief  from  paying  certain 
drainage  bonds  and  interest,  it  is  dubious  if  the  bonds  could  be  sold 
should   the  district  be  organized. 

Florida  is  primarily  a  frontier  state.  It  is  a  state  of  woods, 
streams,  lakes  and  vast  uninhabited  areas.  Its  water  supplies  come, 
and  will  continue  to  come  for  some  time,  from  the  underground  waters. 
Salt  and  brackish  waters  are  found  where  the  largest  cities  are.  thus 
affording  dilution  as  a  method  of  sewage  disposal.  The  Isaak  Walton 
Leagues,  Women's  Clubs,  Garden  Clubs,  etc.,  are  alive  to  the  problem 
of  waste  disposal  and  we  have  little  fear  of  the  troubles  of  the  northern 
and  central  states.  Florida  has  little  manufacturing  that  produces 
troublesome  wastes.  At  times,  our  wood  distillation  plants  cause 
trouble  with  their  wastes,  especially  in  times  of  very  low  run-off. 
Cannery  wastes  have  not  as  yet  entered  the  field  of  stream  pollution. 
The  creamery  development  is  not  extensive  enough  for  consideration 
at  this  time  although  it  is  being  watched  and  guidance  given  when 
possible  to  proper  location  of  these  plants, 

Records  of  sewers  and  data  as  to  connections,  materials  of  con- 
struction and  the  like  are  hard  to  get  due  to  the  deflation  after  the 
boom  and  the  resultant  discharge  by  cities  of  the  engineering  staffs 
that  built  the  sewers.  The  State  Board  of  Health  was  swamped  dur- 
ing the  boom  and  could  not  keep  pace  with  developments.  It  is  felt, 
however,  that  the  time  will  come  when  the  cities  will  take  cognizance 
of  conditions  and  prepare  the  necessary  maps  and  records  of  such  an 
important  utility  as  the  sewer  system. 


The  fallowing  table  gives  the  name  of  the}  community  having  a 
if  these  dala  are  available.  It  Kali  (he  type  "I  sewers,  *»—  — •>- 
detailed  Information  is  available  but  cannot  ba   listed 


having  a  sewer  system— its  population  and  approximate  number  of  people  se 
the  method  of    treatment    and    the    final    disposal    of    the   liquid    waste*, 
due  to  lac  k   of    space. 


irved. 

More 


L 


CITY 


ApalacblcoU 

Arcadia 

Avon    Park 

Bartow 

Blount  etown 

Bonlfay 

h<»y  tit  cm 

Brndcnton 

Brookeville 

Cedar   Key 

Century 

Chi  pie  y 

Clearwater 

Cocoa 

Crystal  River 

Dade  City 

Day  tons    Beach 

DeFuniak  Spring* 

DeLand 

Delray    Beach 

Dunedin 

Dun  net  Ion 

Ellen  ton 

i'rl  n  Midi  II Q 

Foloy 

Ft.   Lauderdale 

Ft,  Meade 

Ft.    Myers 

Ft,    Pierce 

Frostproof 

Giimrnillr 

Craceville 

Green    Cove    Springs 

Hainca  City 

Haatines 
Havana 
Hollywood 
Homestead 

lnverne»> 

Jacksonville    Beach 
Jacksonville 
jasper 
KLsafmmee 
LaBelle 
Lake  Butler 
Lake   City 

|  f  nV.rlniifl 

1    LdML      Vr'staCa 

\\   ™kr    Worth    


PQPULA 

no. 

PEOPLE 

TION* 

SERVED 

3,003 

5.624 

3.000 

3,350 

350 

5.26B 

5.000 

1.256 

250 

1,16} 

1.041 

200 

5.876 

5.000 

2.228 

j  M 

1,138 

300 

.„ 

500 

1,800 

1.500 

7.532 

7.000 

2.162 

2.000 

66) 

350 

1.602 

1,500 

16.761 

1 2.000 

2,531 

_  k_ 

7.429 

3.000 

2.250 

2,000 

1.455 

1,200 

1.103 

1.000 

766 

ISO 

2,835 

3.024 

.  — 

I.00D 

6,445 

1.200 

1.980 

1.500 

8.905 

,IUmtf 

4,772 

4.000 

1,406 

250 

10.530 

8,000 

1,009 

300 

1,605 

1,000 

2,166 

1.000 

673 

400 

2.61  J 

500 

2,939 

300 

2,644 

1,100 

1.356 

1.000 

400 

129,682 

87,000 

2,027 

700 

4.56S 

1 .800 

630 

150 

2,300 

200 

4,412 

4,000 

18.549 

15,000 

|          3.407 

I.OOU 

1          S.BB7 

SEWERAGE— SEWAGE    TREATMENT    AND    DISPOSAL 


Combined    Sewerage — no   treatment- -dilution    into    Brackish    Apslachicola   River 

Separate   Sewers — discharged  raw  into  Peace  River. 

Separate    Sewers — Coarse    bar    screens— Septic    Tank — sand    filtered— Lake. 

Separate    Sewers — Dorr   Clarlfier — separate    sludge   digestion — Creek. 

Separate    Sewers — Septic    Tank — Discharge    into   Creek. 

Separate    Sewere — 2    Septic    Tanks — Disposal    into    small    ditches. 

Separate  Sewers — Septic  Tank— Disposal    into   Brackish   Water — Canal. 

Separate  Sewers— I  I    Outfalls    -No  treatment.      18  Small  Septic  Tanks.      Brackish   River. 

Separate   Sewers — 3    Imhoff  Tanks— Disposal   Into  lake  and  ditches. 

Separate   Sewers— 2   Septic   Tanks — Disposal    Into  Gull. 

Separate   Sewers — No  treatment — Discharge  into  Creek. 

Separate  Sewers — Imhoff  Tank— SopLIc  Tank — Disposal  Into  2  ditches, 

Separate  Sewers — I    Imhoff  Tank — 6   Septic  Tanks — Chlorine — Odor  control.      Salt  Writer 

Separate   Sewers — 2   Septic    Tankr,— Final    disposal    salt    water— Indian    River. 

Separate   Sewers — Imhoff   Tank — Disposal   into   salt  water. 

Separate  Sewers — Raw  and  Septic  Tank  into  Lake. 

Separate  Sewers — Hand  Coarse  Screens-  Mechanical  Fine  Screens- -Chlorine-  Brackish  Water. 

Separate   Sewers — No   treatment — Disposal   into  three   small    streams. 

Separate    Sewers — 2    Imhoif    Tanks — Lake    and    land — Irrigation. 

Separate   Sewers — Septic  Tank — Brackish   Canal   Water. 

Separate  Sewers— 2   Septic  Tanks — I    Imhoff  Tank — Disposal   Into  salt  water. 

Separate  Sewers — No  treatment — Disposal   raw  into  river. 

Separate  Sewers — Septic  Tank  and  raw  into  Brackish   River. 

Separate   Sewers— 3    Septic    Tanks— Discharge    into    Lake    Eustls. 

Separate  Sewers — Discharge   raw  into   Salt  River. 

Separate   Sewera — No    treatment— Discharge    raw    into   river. 

Separate    Sewers — No    treatment — Dilution    in    Brackish    River. 

Separate    Sewers — Septic    Tank    discharges    into    river. 

6  Outfalls — No  treatment  -  (By  passing  Sep.  Sludge  Plant).      Brackish  River. 

Separate  Sewer* — No  treatment — Disposal   raw  Into   Indian  River.    (Salt). 

Separate   Sewers — Septic  Tank   discharging  into  lake. 

Separate  Sewers — Imhoff  and  Septic  Tank — Disposal   into   small  creek. 

Separate   Sewers — Septic  Tank   disposal   Into  creek. 

Combined   Sewers — Disposal    raw    into   St.    Johns   River, 

Separate    Sewers — Oarifier — Separate    Sludge    Digestion       Sand    Fillers. 

Separate   Sewers — Septic   Tank — Disposal   into   creek. 

Separate   Sewers — Septic  Tank — Disposal   into   creek. 

Sewers   take   overflow   from    individual    Septic    Tanks — Disposal   Salt   Water. 

Separate  Sewers — Septic   Tank — Disposal   into    Ditch. 

Separate   Sewers— 4    Septic   Tanks — Disposal   into  lake. 

Separate  Sewers — No    Treatment — Disposal    into   Brackish  Water. 

Separate    Sewers — No    treatment — Discharge    raw    into    Si.    Johns    River. 

Separate   Sewers — Disposal    by    Dilution    raw   Into    creek. 

Separate    Sewers — 7    Septic    Tanks — Disposal    into    ditches. 

Separate    Sewer* — Disposal    raw    Into    river. 

Separate  Sewers — Septic  Tank  and  dilution   Into   ditch. 

Separata    Sewers — Clarlfier— Separate   Sludge   Digestion — Chlorine — Sprinkling   Filters. 

Final  Sedimentation — Disposal  into  Stream. 

Separate  Sewers — Fine  Screens— Clarlfier — Separate  Sludge   Digestion — Ditch. 

Separata    Sewers — Septic    Tank — Dilution    In    Lake. 

Separate     Sewer. Septic    Tnnk.    and    di«p<l»al    in     mail    lake. 


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'                       CITV 

1  INOCULA- 

I'EOPLE 
SERVED 

TION* 

La  tit  ana 

200 

100 

Largo 

Ml  6 

Lee  a burg 

4.109 

3.000 

Live  Oak 

2.837 

9.500 

Lynn    Haven 

1.077 

200 

Vtadi.on 

1.600 

1,000 

Manatee 

3,219 

1.500 

Monannd 

3.434 

2.000 

Melbourne 

2.642 

Miami    Beach 

6.474 

6,47"4 

Miami 

110,025 

60,000 

Milton 

2,581 

I.OOO 

MonLlceMo 

1.S23 

Ml.   Dora 

1.612 

~200 

Mulberry 

2.029 

1.500 

New   Port    Ricbey 

756 

500 

New   Smyrna 

4.149 

3.500 

Ocala 

J.275 

6.500 

Okeechobee 

,„,„.,   ,. 

too 

Orlando 

27,263 

25.000 

Palatka 

6,397 

4,000 

Palm   Beach 

1,673 

1.500 

Palmetto 

3,034 

1.500 

Panama  City 

5.166 

|,00fl 

Pen.acola 

31.455 

25,000 

Perry 

2.823 

Plant   City 

6.811 

Pompano 

.1.4*2 

150 

Punt*   Gor da 

2,100 

2.000 

Quiney 

4,311 

3,000 

Safety   Harbor 

760 

300 

Sanford 

10.003 

S.362 

Saraaota 

8,385 

6.000 

Sri  II  ill  K 

2,797 

1.000 

South    Jacksonville 

5,654 

5.000 

Starke 

1,275 

800 

St.   Augualine 

13,266 

12,000 

St.   Cloud 

1,855 

1,200 

St.     Petersburg 

39.504 

1 8,000 

Stuart 

1.400 

500 

Tallahaiaee 

10,744 

4.000 

Tampa 

1 00,9 1 0 

, 

Tarpon   Spring** 

3.418 

2.500 

Tltuivllle 

2.080 

500 

Umatilla 

975 

250 

Vero   Beach 

2.272 

2.000 

Wauchula 

2.574 

r m 

We.t    Palm    Beach 

21.328 

_ 

White    Springs 

800 

200 

Witdwood 

979 

250 

Williaton 

594 

300 

Winter    Garden 

2,321 

1,000 

Winter   Haven 

7.1  IB 

1.500 

Winter    Park 

3.646 

1.500 

Zollo    Spring* 



100 

StWKRAaE SEWAGE      TRliAtMENT      AND       LrJit'OSAL 


Separate    Sewers — Disposal    raw    into    call    Lake   Worth- 
Sap*  rate    Sewers — Septic   Tank   and   dilution    in    ditch. 

Separate    Sewers — Disposal     through     Septic    Tank    and    dilution    in    ditch. 
Separate    Sewers — Septic    Tank — Disposal     through    drainage    well*. 
Separate   Sewer* — Disposal    through    Septic    Tank — Dilution    in    Brackish    Water, 
Separate   Sewer* — Septic   Tank — Final   disposal   in   ditch. 
Separate    Sewers — Discharging    raw   into    brackish    Manatee    River. 
Separata   Sewer* — No   Ireatment — Discharge*   row   into   Lime   Rock    crevices. 
Separate   Sewer* — 3   Septic   Tanks   discharging   into   brackish   water*. 
Separate   Sewers — Discharge   raw  in  salt  water  on  outgoing   tide. 

Separate   Sewer* — Small   portion   fine   screened — Most   discharged   raw   in    salt  water. 
Separate    Sewers — Discharge    raw   into   brackish    river. 
Separate    Sewers — 4    Septic    Tank* — Dlschorge    Into   ditches. 
Separate    Sewer* — Septic   Tank    discharges    into    lake. 
Separate  Sewer* — Imhoff  Tank  di* charge*   into   river. 
Separate  Sewer* — Septic  Tank   discharge*   into   brackish   river. 
Separate    Sewers — Discharge    raw    into    salt    water. 

Separate  Sewers — Imhoff  Tank   roughing    Niter — Chlorine — Disposal    in   drainage   wells. 
Separate   Sewer* — Discharges   raw  and  Septic   Tank   effluent  into  creek. 
Separate   Sewer* — Discharge    through    Septic  Tanks   Into   drainage   well*. 
Separate  Sewers— Discharge  raw  into  Si.  Johns  River. 
Separate   Sewers — Discharge    raw  into  brackish    Lake    Worth. 

Separate    Sewers^— Disposal    through    2    Septic    Tanks   and    raw    into    brackish   water— river, 
Separate   Sewer* — Disposal    raw   and   through    2    Septic  Tank*    Into    sott    water. 
Separate   Sewer* — -Discharge   raw   into   salt   water. 
Separate    Sewers — Discharge    raw   into   creek. 

Separate    Sewers— I  mho  ff    and    Septic   Tank*    discharge    Into   ditch**. 
Separate    Sewers— Discharge    through    Septic    Tank    into    ditch. 
Separate    Sewers — Discharges    through    2    Septic    Tanks    into    brackish    water. 
Separate   .Sewer* — Discharge   through   Septic   Tanks   into   creek. 
Separate  Sewers — Discharge    through  Septic   Tank   into  brackish  water. 
Combined   Sewers- — Discharging   raw   into   St.    John*   River. 

Separate   Sewers — Discharge   raw   and    through    Septic  Tanks   into  salt   Water. 
Separate    Sewers— Septic    Tank — Sand    fitters. 
Separate   Sewer* — Discharge   raw   into   St.    Johns   River. 
Separate   Sewer* — Dkherge    through    Imhoff   Tank*   into   creek. 
Separate   Sewer* — Discharge    raw   into   salt   water. 
Separate   Sewers — Discharge    through    Septic   Tank*    into  lake. 
Separate    Sewers— Mechanical     coarae    and    fine    screen — Chlortnation. 
Disposal    into    salt    water. 

Separate   Sewer* — Discharge   raw   into  bracklah   water. 

Separate    Sewers — D  is  charge    through    Septic    Tank   and    contact    bed*    into   ditches. 
Separate   Sewers — Imhoff   Tank — Septic   Tank    and   raw   sewage   Into   brackish   waters. 
Separate    Sewers — Discharge    through    Septic    Tanks    into   brackish    waters. 
Separate    Sewers — Discharge   through    Septic    Tanks   into    ditches. 
Separate   Sewers — Discharge   through   Septic   Tank  Into   Lake. 
Separate   Sewers — Clarlffer — Separate   sludge   digestion — Disposal   into   ditch. 
Separate  Sewer* — Discharge    raw   and    through    Septic   Tank   into  river 
Separate   Sewer* — Discharge   through   Septic  Tank  into   salt  water. 
Separata   Sewers — -Discharge    through    Septic    tank   into    river. 
Separate    Sewers — Imhoff    Tank — -Oil  or  mat  ion — Disposal    Into    drainage    well. 
Separata   Sewers — Disposal    through    Septic   Tank*    into   Lime   Sink    Hole. 
Separate   Sewer* — Discharge    through    Septic   Tank    Into    Lake. 
Separata   Sewers — Discharge   through   Septic  Tank   into   Lake. 
Separate   Sewers — Ducharge   through    Imhoff   Tank   Into  creek- 
Separate   Sewers — Discharges    raw   into   creek 


_UI  IV         J^II1II1J  ^ I^__  a  ajF-a.  M^o^aa.  a  oa  a  w       Miiw^l. l^liUIIMI  q1*1*       alTT       1JJ  IU      a,  ■  ynoij 

Population   flgurea  eecured   from   new.  pa  per   releaaaa,   city  dark*  and  ealimatei   when   no   official   fig  urea    wan   available 


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160 FLORIDA  STATE  BOARD   OF   HEALTH 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 
Luciie  Spire  Blachly,  M.  D.,  Director 

PHYSICAL  EXAMINATION  BLANKS  FOR  TEACHERS 

Requests  are  now  coming  in  for  physical  examination  forms  for 
teachers.  Heretofore,  two  blanks  have  been  supplied — one,  merely 
a  statement  from  the  doctor  to  the  effect  that  the  applicant  has  been 
examined  and  no  evidence  of  communicable  disease  found;  the  other, 
a  fairly  comprehensive  card  covering  the  physical  findings  but  with  lit- 
tle space  for  the  history  and  present  health  habits  of  the  candidate. 
Both  forms  seem  inadequate  so  the  periodic  health  examination  forms 
prepared  and  published  by  the  American  Medical  Association  are  be- 
ing offered  to  all  applicants.     This  form  is  8  x  10J/2  inches  with  space 

for  data  on  both  sides one  side  covering  the  usual  social  data,  i.   e., 

name,  address,  age,  etc.;  occupation;  conditions  of  work,  whether  sat- 
isfactory, monotonous,  fatiguing;  home  conditions,  whether  congenial, 
depressing,  quiet,  irritating;  sleeping  conditions,  hours  in  bed,  windows 
open,  restful  or  disturbed;  food  habits,  as  to  regularity,  quantity,  eat- 
ing between  meals,  time  of  meals,  variety — as  regards  meats  and  pro- 
teins, green  leafy  vegetables,  potatoes,  pastries,  sweets,  fruits,  salads; 
liquids  used,  kind  and  quantity;  candy  and  sweet-meat  habits;  use  of 
tobacco;  habits  of  elimination;  exercise;  social,  political,  and  club 
associations;  recreations;  hobbies;  tendency  to  worry;  moods,  periods 
of  alternating  gloom  and  cheerfulness;  past  and  present  illnesses,  i,  e,, 
tuberculosis,  malaria,  frequent  colds,  severe  headaches,  etc. ;  present 
indispositions,  loss  of  appetite,  colds,  cramps,  palpitations;  immuniza- 
tions and  vaccination  status  and  history;  history  of  accidents;  present 
condition  of  teeth  and  mouth;  habits  of  going  to  the  dentist;  family 
history;  special  queries.  On  the  opposite  page  space  is  allowed  for 
physical  data  with  room  for  summary  and  advice  to  candidate. 

Although  not  perfect,  this  form  has  many  advantages  over  most 

others,  among  them  being,    (a)   the  applicant  may  fill  out  the  history 

and  habits — side  of  the  card  in  his  own  room,  thus  giving  him  ample 
time  to  call  to  mind  any  and  all  deviations  from  the  normal  so  the 
examining  physician  may  have  a  true  mental  picture  of  the  applicant 
when  he  makes  the  examination;  (b)  space  for  defects  found  is  so 
arranged  that  none  need  be  wasted  on  negative  findings. 

It  is  assumed  that  now  that  the  recommendations  of  the  Joint 
Committee  of  the  National  Education  Association  and  the  American 
Medical  Association  have  had  a  period  of  nearly  a  decade  in  which 
to  permeate  the  consciousness  and  consciences  of  the  teaching  fraternity 
there  is  no  teacher  left  who  feels  he  has  discharged  his  duty  to  himself. 
his  family — born  or  unborn — or  his  pupils,  when  he  simply  rushes  in 
to  his  old  family  physician  and  well-wisher  with  a  hurried  request  to 
sign  him  up  as  all  "fit  as  a  fiddle"  so  he  can  "get  the  job."  Tbat  sort 
of  thing  is  on  a  par  with  the  intelligence  used  by  the  nitwit  of  the  nine- 
ties who  is  reported   (by  vaudevillists)   to  have  slipped  his  letter,  un- 


FLORIDA  STATE  BOARD   OF  HEALTH [61^ 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

stamped,  into  the  slot  of  the  village  post  office  when  the  postmaster 
wasn't  looking. 

Teachers  are  human  beings  and  all  human  beings  are  subject  to 
physical  and  mental  ills.  These  ills  are  much  more  amenable  to  treat' 
ment  and  to  complete  cure  if  detected  in  their  incipiency.  Likewise, 
the  detection  of  disease  in  its  incipiency  is  unquestionably  more  diffi- 
cult, as  well  as  more  important,  than  after  it  is  we  11 -established,  so 
time,  skill,  preparation,  and  equipment  are  necessary  essentials  on  the 
part  of  the  examiner,  and  time  and  active,  sympathetic  cooperation 
on  the  part  of  the  candidate  are  imperative. 

Experience  has  shown  that  the  periodic  physical  examination  is 
a  factor  in  the  extension  of  the  span  of  life  and  increases  the  efficiency 
of  the  examined  to  such  a  degree  that  the  monetary  cost  is  returned 
many  fold  to  the  candidate  during  his  life  time — not  to  mention  the 
added  happiness  that  comes  from  healthful  Uving  habits  so  rendered 
possible.  A  simple  request  stating  name,  age,  and  school  will  bring 
you  the  proper  form. 

Theodore  Roosevelt  has  said:  "Every  man  owes  something  to 
the  up-building  of  the  profession  to  'which  he  belongs."*  There  is  no 
better  way  of  building  up  the  teaching  profession  than  for  the  teacher 
to  set  the  example  of  intelligent  conservation  of  health  for  his  pupils 
and  his  community. 

Maternity  Letters 

The  Bureau  of  Child  Hygiene  and  Public  Health  Nursing  has  two 
sets  of  letters  for  the  expectant  mothers  of  Florida — one  for  those  who 
intend  using  a  midwife  for  the  delivery,  the  other  for  those  who  in- 
tend using  a  physician. 

If  the  reader  desires  these  letters  for  herself,  some  member  of  the 
family,  some  friend  or  neighbor,  please  fill  out  the  coupon  below,  giv- 
ing the  name  of  the  expectant  mother  and  send  it  to  Bureau  of  Child 
Hygiene  and  Public  Health  Nursing,  State  Board  of  Health,  Jackson- 
ville,  Florida. 

Address     „ — — — _ 


Date  of  Expected  Confinement  _ .. — „ 

No.  living  children No.  children  dead 

Age .... - :  Color. — ™ 

Will  a  doctor  or  a  midwife  attend  confinement? 

Referred  by  — . — . 


State  whether  the  above  is  a  nurse,  doctor,  midwife,  friend,  or  relative. 


162 FLORIDA  STATE   BOARD  OF  HEALTH • 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

MILLIONS  FOR  DEFENSE 

It  is  now  twenty-seven  years  since  the  presence  of  hookworm 
disease  was  recognized  by  Drs.  Adamson  and  Helms  of  Tampa  and 
called  to  the  attention  of  the  State  Board  of  Health.  This  marked  the 
beginning  in  Florida  of  the  sanitation  and  treatment  campaign  for  the 
eradication  of  the  disease  which  has  not  yet  been  finished  and  will 
not  be  until  our  fair  State  is  free  of  the  parasite.  Such  a  happy  event 
will  transpire  when  every  householder  adopts  such  measures  as  will 
prevent  the  contamination  of  soil  with  human  wastes. 

The  twenty-seven  year  campaign  may,  indeed,  have  cost  the  State 
millions  of  dollars  in  services  rendered  by  the  State  Board  of  Health 
alone.  These  services  have  included  free  laboratory  diagnosis,  free 
distribution  of  drugs,  printing  and  distributing  educational  bulletins 
and  the  field  service  of  doctors,  nurses  and  sanitary  officers.  Other 
defense  costs  paid  by  county  and  city  governments  and  individuals 
cannot  be  even  roughly  estimated  but  must  have  been  enormous. 

How  Much  For  Tribute? 

Although  an  amazing  amount  of  good  has  been  accomplished  by 
our  consistent  efforts  to  eradicate  the  hookworm,  we  are  still  sustaining 
a  large  annual  loss  from  its  ravages.  We  do  not  see  nearly  as  many 
children  who  are  obvious  and  extreme  sufferers  but  still  there  are  too 
many  of  these  in  the  more  remote  rural  sections  where  medical  atten- 
dance is  not  easy  to  get. 

There  are  many  others  who,  though  not  severely  affected,  are 
yet  laboring  under  a  handicap  of  lesser  degree. 

There  is  no  doubt  that  hookworms  render  one  more  susceptible 
to  other  diseases,  particularly  tuberculosis  and  malaria. 

Who  Cares? 

Even  practicing  physicians  want  to  see  hookworm  disease  eradicated. 
Rather  than  a  source  of  revenue  it  is,  to  them,  as  to  everyone,  an  eco- 
nomic handicap.  Teachers  who -want  their  pupils  to  do  creditable 
work  and  preachers  who  seek  to  raise  the  spiritual  and  moral  tone 
of  their  people  are  arch  enemies  of  his  satanic  majesty,  the  hookworm. 
The  merchant  can  sell  more  goods  and  collect  more  promptly,  the 
employer  can  get  more  work  from  his  help  and  the  employee  can 
earn  better  pay  if  the  hookworm  handicap  is  removed  from  the  com- 
munity. Parents  can  enjoy  their  children  more  and  children  will 
better  appreciate  their  parents.  In  short,  there  is  no  individual,  class 
or  business  interest  but  is  injured  by  the  presence  of  hookworm  dis- 
ease and  benefited  by  its  eradication. 


FLORIDA  STATE   BOARD   OF   HEALTH [63 

BUREAU  OF  COMMUNICABLE  DISEASES 

There  is  but  one  way  to  get  rid  of  hookworms  and  that  is  by 
sanitation.  It  can  be  done  individually  or  collectively.  The  cost  is 
relatively  low  and  the  returns  enormous.  You  can  get  full  directions 
from  the  State  Board  of  Health. 


To  Report  or  Not  to  Report 

During  the  first  week  of  September,  morbidity  reports  were  re- 
ceived by  this  Bureau  from  fourteen  counties  and  out  of  the  other 
fifty-three  counties  with  a  total  population  of  JSO.OO'O,  not  one  case 
of  any  of  the  forty  reportable  diseases  was  reported. 

The  statutes  of  Florida  and  the  rules  of  the  State  Board  of  Health 
are  specific  in  requiring  that  every  person  who  treats  or  examines  any 
person  having  or  suspected  of  having  a  notifiable  disease  must  report. 
This  includes  not  only  doctors  but  school  teachers,  hospital  superin- 
tendents, etc.,  and  a  penalty  as  for  misdemeanor  may  be  imposed  for 
failure  to  report. 

There  is  no  reasonable  excuse  for  neglect  or  failure  to  report. 
Report  cards  are  furnished  free  on  request  and  no  postage  is  required. 

The  State  Board  of  Health  is  endeavoring  to  render  service  to  all 
the  people  of  Florida.  The  doctor  who  fails  to  cooperate  by  con- 
cealing or  failing  to  report  is  doing  himself  and  his  patrons  an  injus- 
tice. He  is  assuming  an  unnecessary  and  unwarranted  responsibility, 
exposing  his  community  and  perhaps  his  own  family  to  the  dangers 
of  preventable  disease  and  laying  himself  liable  to  prosecution. 

Although  quarantine  becomes  automatically  operative  upon  rec- 
ognition of  a  quarantinable  disease  and  although  physicians  usually 
discharge  their  duty  to  isolate  immediately,  the  power  to  quarantine 
is  vested  primarily  in  the  State  Board  of  Health  and  the  responsibility 
for  protection  of  the  public  is  accepted  when  the  report  is  received. 

Pellagra 

Deficiency  of  diet  is  quite  generally  accepted  as  the  cause  or  at 
least  one  of  the  causes  of  pellagra.  Most  of  the  patients  are  found 
to  have  eaten  an  unbalanced  diet,  although  some  few  of  these  have 
been  provided  with  proper  food  and  failed  to  eat  properly. 

Unemployment  and  the  attendant  shortage  of  funds  probably  ac- 
counts for  this  year's  increase  in  pellagra.  Fresh  milk,  eggs,  meat, 
fruit  and  vegetables  should  be  included  in  the  daily  diet.  Brewer's 
yeast,  fresh  or  dried,  and  a  liberal  allowance  of  tomatoes  or  tomato 
juice  seem  to  contain  most  valuable  curative  substances.  Every  pa- 
tient should  be  attended  by  a  physician. 


164 FLORIDA  STATE  BOARD  OF  HEALTH 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H-,   Director 

HIGH  SCHOOL  AGE  MORTALITY 


ftEc6aos 


Many  of  our  Florida  cities  are  justified  in  boasting  of 
their  beautiful  high  school  buildings.  There  are  more 
of  our  fine  boys  and  girls  in  high  school  this  fall  than 
in  any  other  period  in  the  history  of  our  nation.  Good 
teachers,  fine  buildings,  playgrounds,  gymnasiums  and 
athletic  teams  at  all  times  command  the  interest  of  parents  and  the  pub- 
lic in  gereral.  Every  high  school  boy  and  girl  should  have  protection 
from  unnecessary  and  preventable  disease  and  accident.  It  is  reasona- 
bly easy  to  attract  the  attention  of  high  school  officials,  city  officials, 
our  parent-teacher  associations  and  others  to  the  necessity  for  proper 
ventilation,  protection  against  fire  hazards  and,  to  a  more  or  less  de- 
gree, medical  examinations  and  sanitation.  When  it  comes  to  the  boy  or 
girl,  however,  who  falls  out  of  the  ranks,  stays  at  home  for  a  period 
and  then  passes  away,  he  or  she  may  be  missed  for  a  short  time  but 
eventually  'will  be  forgotten.  The  termination  of  a  life  may  have  been 
due  to  typhoid  fever,  tuberculosis,  automobile  accident  or  other  pre- 
ventable cause. 

The  value  given  in  protection  by  life  insurance  is  accepted  uni- 
versally in  this  country.  Premiums  for  life  insurance  are  governed 
by  data  secured  through  the  classification  of  information  contained 
in  death  certificates.  Your  attention  is,  therefore,  directed  at  this  time 
to  the  leading  causes  of  deaths  in  the  age  group  15  to  19,  inclu- 
sive, which  very  closely  adheres  to  what  is  known  as  the  high  school 
age.  In  the  Health  Notes  of  October  last  year,  the  percentage  of 
deaths  from  the  ten  leading  causes  of  deaths  in  the  age  group 
to  which  we  have  just  referred  appeared  on  pages  1  34  and  1 35  by 
color  in  graphic  form.  Similar  charts  appear  in  this  issue  for  1 929 
which   is   a   year    later. 

The  greatest  killer  last  year  in  what  we  have  termed  the  high 
school  age  (for  whites)  was  accidents  from  automobiles.  This  should 
be  a  warning.  Is  there  any  unnecessary  risk  taken  by  boys  and  girls 
of  high  school  ages?  Are  the  deaths  charged  against  this  cause  from 
accidents  en  route  to  and  from  high  school  or  during  high  school  as- 
sembly periods?  Since  the  automobile  represents  the  greatest  danger 
to  the  life  of  the  high  school  boy  and  girl,  it  is  a  problem  which  should 
challenge  the   attention  and  action  of  those  in  power. 

One  of  the  outstanding  features  presented  by  the  first  chart  (for 
white  population)  is  that  tuberculosis  does  not  appear  as  one  of  the  ten 
leading  causes  of  death  in  this  age  group  while  for  the  previous  year 
(1928)  tuberculosis  ranked  fifth.  Typhoid  fever  ranks  sixth  for  1929 
and  held  the  same  rank  for  the  previous  year.  This  preventable  disease 
might  well  receive  more  attention  in  the  high  school  age.  Homicides 
are  not  included  while  this  cause  ranked  tenth  in  the  publication  last 


FLORIDA   STATE   BOARD   OF   HEALTH 


165 


BUREAU  OF  VITAL  STATISTICS 

year.  Chronic  nephritis,  you  will  note,  is  eighth  and  heart  disease 
ninth,  out- ranking  tuberculosis  and  homicides  last  year  among  white 
boys  and  girls  of  this  age. 

It  would  be  interesting  to  comment  on  the  ten  leading  causes  in 
this  group  among  the  boys  and  also  among  the  girls  as  well  as  to  dis- 
cuss the  causes  most  fatal  to  the  colored  population.  Since  space  will 
not  permit  such  a  discourse,  the  first  column  of  the  first  chart  has  been 
used  for  comment  which  is  under  the  caption  "Total  White."  Those 
who  are  interested  will  be  able  to  continue  the  study  by  comparing 
the  two  charts  in  this  issue  with  the  ones  published  in  October  of  last 
year. 


Grow  Old  Happily 

Growing  old  happily  is  a  matter  of  adjustment  to  the  inevitable 
physical  and  mental  changes  that  accompany  age.  The  factors  that 
make  for  successful  adjustment  are:  good  heredity,  sound  physical 
health  and  unimpaired  senses,  satisfactory  social  environment  and 
economic  independence  and  security,  according  to  Dr.  Clifford  B. 
Farr,  a  specialist  in  mental  hygiene,  writing  in  Hygeia  for  October. 

Mental  hygiene  is  frequently  consciously  employed  by  persons 
■who  are  entering  the  period  of  advanced  life  and  they  need  no  outside 
help  or  interference.  Others,  however,  especially  those  who  take  too 
depressive  a  view  of  life,  need  advice  and  encouragement  to  enable 
them  to  spend  this  age  period  happily. 

On  the  whole,  under  favorable  conditions  of  physical  and  mental 
health  and  normal  average  environment,  advanced  life  is  not  a  period 
of  undue  mental  hazards,  but  one  in  which  we  tend  to  make  the  most 
successful  personal  adjustment. 


j\  I  A  LITTLE,  PBAWIH6  LEaSQK 


pThis  is  howjou.  dray  a  HALLO  WEEfT  pu«y  in  five  stages,  ] 


O  A.P.H. 


166 


HUMAN  LIFE  IS  THE  STATES  GREATEST  ASSET 


BUREAU  OF  VITAL  STATISTICS 

Leading  Causes  of  Death  in  Age  Group   15-19 
White  Population 1929 


AutaatAila  toaUmU  -  U  0 


Atrt<"Jobll»  uoUati  -  14  % 


Stat*  -  IS  * 


Puarparal  3tata  -  8  t 


Jneu>ool«  -  6  % 
(All  Tan*} 


Pnawonla  -  1  % 
(AUTorw) 


infl' 
(All 


1* 


AutO»t>ll>  Aooidant*  -   10  * 


Influan  -  5  * 
(All  rem) 


Accidental  tfroiulng  -  5  i 


AppandleltU  -  6  J( 


App«oalaltl>  -  5  $ 


Homloidoo  -  5  % 


Trpboid  Inn  -  4  * 


pnmasonla  -  S  £ 
(All  r«™> 


AppaaalsltlA  -  4  ]C 


IblarU  -   4  < 


Tjjholfl  Fo»«r  -  5  )l 


Malaria  -  4  < 


Chroola  Haphr  ltia  -  4  * 


SulaldM  -  4  i> 


Baar*  Dieaaaa  -  5  % 


Eaart  H1M4M  -  4  % 


OSroota  Saptaritla  -  3  £ 


AMlaaotal  Moving  -4* 


Tobaronloaia  -  5  # 
(AH  Pom.) 


Traiaatlaa  by  fixm™  -  a  < 


Cbraaia  NaphrltiJ  -  5  < 


atgaagi 


Malaria  -  4  % 


m»tii" 


Influenza  -  4  3t 
(AUTonaa) 


"We  stop  playing,  not  because  we  grow  old;  we  grow  old 

because  we  atop  playing." 

Herbert  Spencer, 


FLORIDA   STATE   BOARD   OF   HEALTH 


167 


BUREAU  OF  VITAL  STATISTICS 

Leading  Causes  of  Death  in  Age  Group   15-19 
Colored  Population  —  1929 


TOTAL  COLORS 


FBTUT 


Tubarauloal*  -  £3  Jt 
(HI  ram) 


Puvpvti  Stat*  -  a  i 


lafluani*  -  7  f 
(all  Tonal 


It  -  s  * 


HoBleldu  -  8  * 


(1U  Tom) 


5< 


Tubarouloala  -  M  # 
[All  Tina) 


TUDorauloaU  >U( 
[HI  Tom) 


Influaua  -  fl  < 
[All  Tom) 


Fnarparal  Stata  -  14  # 


Malaria  -  8  * 


Inf  ltmaa  -  8  * 
(all  fom) 


Baalsldaa  -  S  * 


Dlaaaaa  -  ft  * 


Haart  Dlaaaaa  -  4  # 


Sjpbilla  -  3  * 


Tpavnatlam  by  Tixaama  -  S  % 


Pallagr*  -St 


izsxa 


iiHl 


Railroad  Aaoldaot*  -  ft  * 


Jna™onl»  -  8  4 
(ill  Tom) 


Ttwinatlaa  by  ri 


5* 


Malaria  -  5  * 


aeeldtotal  Htming  -  A  % 


Pallagra  -  3  * 


ptmmonla  -  3  f 


8* 


Typhoid  Tmr  -  2  < 


3# 


Syphllta  -  B  * 


Ckrqnle  KapbrltLf  -  3  < 


168 


FLORIDA   STATE   BOARD   OF   HEALTH 


•CU£~&  .  .ii 


EE  how  many  things  that  are  good  for  your  health  you  an  syo\\.  out  by- 
travelling  from  one  star  to  another  Some  of  them  are  juggested 
in  the  snag  squares,  and  there  are  at  least  ei  jht  all  together. 


This  Issue  Exceeds   I  2,000  Copies 
! 


pLORID^ 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED   JULY,    1892 

STATE  BOARD  OF  HEALTH 


En  l*  red   ••   Second   Oui   Matter.  October  27.   1921 
■t  the   Foitoflice  at  Jacksonville,   Florida.  Under  the  Act   of  Aueutt   24,    1911 


JACKSONVILLE,  FLORIDA 

red   ma   Second   Oaee   Mattar.   October   27. 
t  Jacksonville,   Florida,  Under  the  Act  < 

Thie  Bulletin  will  be  aerit   to  any  addreae  in  the  State  free  of  charge. 

Vol.  22  NOVEMBER.    1930  No.    11 


Edited    by 

STEWART  C.  THOMPSON,  D.P.H..  Member 
American   Medical    Editor*'   and    Author*'    A**n. 


SPECIAL  ARTICLES 

HERE  AND  THERE  —  Filby 

PREVENT  PELLAGRA  —  Brink 

HEALTH  AND  ECONOMICS  —  Hanson 

CERTAIN  PREVENTABLE  DEATHS  —  Thompson 

THE  NEW  PROGRAM  IN  THE  FIELD  —  Blackly 

THE  LABORATORY'S  PLACE  IN  MEDICINE  —  Eaton 


HENRY  HANSON.   M.  D..  STATE  HEALTH  OFFICER 


170 


FLORIDA   STATE   BOARD   OF   HEALTH 


H.    Mason    Smith,     M. 
Tampa 


Pres. 


BOARD    MEMBERS 

Henry    E*    Palmer,    M. 
Tallahassee 


E.  d  wa  r  d     M .     1/E.n  gle»    M*     D 
Jacksonville 


STATE   HEALTH    OFFICER 
Henry    Han* on,    M.    D. 


BUREAUS   AT  JACKSONVILLE 


Diagnostic    Laboratoriea... 
■Vitul    Statistic*.., 


Communicable   Diseases- 
E  n  gi  nee  rin  g- 


Child  Hygiene  and  Public  Health  Nursing. 
Account  ing- 


Crippled    Children- 


DIRECTORS 

Paul    Eaton.    M.   D.,    D.    P.   H. 

Stewart    C.    Thompson.    D.    P.    H, 
F.   A.   Brink.  M.    D. 
Ellsworth   L.  Filby,  C.  E. 
Lucile    Spire   Blachly,   M.   D. 
Screven    Dozzer 
F.   L.   Fort,  M.   D. 


"550    Local    Registrars     (County    list    furnished    on    request). 

■  Registration   Inspector Anna    C.   Emmons 

Drug    Store    Inspector——— — .— — , .— — ^    H.    R.    Monroe 


LABORATORIES 


Jacksonville... 

Miami — 

Pen  sa  cola 

Tallahassee 

Tampa 


Peart    Griffith,    B.    E. 
E.   R.    Powell 
Johnette  McCormick 
Jane    B.    Currie,    B.    S. 
H.     D.    Venters,    B.    S. 


MEDICAL   OFFICERS 


DeFuniak    Springs. 

Jacksonville! 

Vero    Beach 


Tallahassee- 
Tampa- 


Brooksville  - 


C.   W,    McDonald.   M.   D. 

B.  C.   Wilson.  M.    D. 
W.   A.  Claiton,  M.   D. 
H.   A.    MeClure.    M.   D. 

C.  W.   Pease.  M.  D. 
A.  C  Hamblin.  M,  D. 


Jacksonville- 
Jacksonville- 
Miami 


Ocala. 


DISTRICT  SANITARY  OFFICERS 


Orlando 

Pun  la     Gorda 

Taltaha  a  aee 

Tampa... 


V.   B.    Lam  aureus,    C    E, 
Fred   A,    Safay 
George    B.    Reed 
C.    A.    Ho  Ho  way 
Russell     BToughman 
C.    A.    Renney 
C    N.    Hobbs 
O.    H.    Otbum 


Jacksonville... 
Arcadia- 


PUBLIC  HEALTH   NURSES 


DeFuniak  Spring* 

Eden,   R.    F.   D.   Jense 
Lake    City 

M  a  ri  anoB t 

Rusk  in 

S  la  rke 


Clio  McLaughlin,   R.   N. 
Jule    Craves,    R.    N. 
Nanna    Colby,    R,   N. 
Sarah    Ida    Richard  a.    R,    N. 
Frances  Hall.  R.   N. 
Lalla  Mary  Coggans,  R.  N. 
Joyce  Ely.   R.  N. 
Mary    C.    Dodd,    R.    N. 


Jacksonville- 


COUNTY  HEALTH   UNITS 

E.  C.  Stoy   IV,  S.   P.  H.  S.) 


FLORIDA  STATE  BOARD   OF  HEALTH ]7} 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

HEALTH  AND  ECONOMICS 

One  appearing  before  Civic  Clubs  often  wonders  what  the  in- 
dividual interest  of  the  club  is.  Why  does  one  belong  to  a  club? 
In  the  present  disturbed  social  and  economic  conditions  everyone 
is  seeking  adjustments  and  offering  panaceas  for  the  prevailing  ills. 
As  I  travel  over  the  state,  I  hear  many  proposals  for  correcting  un- 
satisfactory conditions  and  it  would  appear  that  the  coming  legisla- 
ture is  to  be  a  very  much  occupied  body  of  men. 

The  most  startling  remedy  proposed  is  that  of  reducing  the 
salaries  of  all  state  officials  including  the  Governor  and  his  cabinet. 
This  is  so  absurd  as  not  to  be  worthy  of  note  but  I  mention  it  to 
illustrate  a  trend,  a  mental  state  engendered  by  the  unprecedented 
number  of  bank  failures  following  a  wicked  boom.  A  mental  state 
of  this  kind  is  an  illustration  of  grasping  at  straws  and  letting  the 
beams  and  floats,  which  would  support  and  carry  one  over  the  crises, 
pass  by  unobserved.  The  result  of  action  of  this  kind  is  graphically 
illustrated  by  an  assumption  that  if  the  entire  salary  of  the  Governor 
and  his  whole  cabinet  were  wiped  out  the  man  who  pays  taxes  on 
$1000.00  of  assessed  valuation  would  save  11.6^  a  year.  Since  it 
is  not  proposed,  however,  to  take  their  entire  salaries  away  the  saving 
would  be  too  small  to  be  noticed.  It  would  seem  that  more  sound 
thought  should  be  given  to  the  proposed  remedies  and  if  economies 
are  to  be  practiced  they  should  not  be  of  such  a  nature  as  to  dis- 
courage or  disrupt  the  morale  of  officials  within  the  state  -who  at  the 
present  time  are  not  receiving  more  than  a  very  modest  income  which 
permits  only  a  bare  living  without  any  provision  for  that  period  of  life 
when  one's  activity  is  reduced  and  when  one  should  have  something 
laid  up  to  take  care  of  an  on-coming  old  age. 

The  above  may  lead  one  to  think  that  there  are  other  interests 
wishing  to  hide  matters  having  a  more  direct  bearing  on  the  high  tax 
rate  and  in  centering  attention  on  a  futile  spectacular  effort  to  camou- 
flage the  real  "nigger  in  the  wood  pile." 

I  am  in  entire  sympathy  with  sound  economy  but  there  are  a 
group  of  public  officials  who  are  indispensable  to  government  and 
who  must  devote  their  entire  time  and  energy  towards  the  discharge 
of  the  function  of  government  office.  If  such  individuals  are  not 
paid   a  living,   they  are  forced  to  seek  income  from   outside  sources. 

It  is  not  my  plan  to  discuss  either  general  legislation  or  general 
economics  but  1  hope  to  indicate  some  conditions  prevailing  in  the 
general  health  of  Florida  which  may  point  to  the  possibility  of  a 
greater  revenue  from  approximately  the  same  amount  of  energy 
expended.  It  has  been  the  experience  of  all  great  enterprises  estab- 
lished in  tropical  and  subtropical  countries  that  the  first  point  of 
consideration  is   health.       The     old     outstanding    illustration    of    the 


172 FLORIDA   STATE  BOARD   OF   HEALTH 

ADMINISTRATION 

Panama  Canal  is  one  of  the  most  conclusive  of  such  examples.  The 
Americans  found,  in  1906,  that  yellow  fever  was  only  one  of  the 
factors  which  militated  against  the  successful  building  of  the  Canal, 
The  greatest  obstacle  at  that  time  appeared  to  be  malaria.  The 
Tropical  Oil  Company  when  it  began  its  operations  in  Beranca 
Bermeja,  on  the  Magdalena  River  in  Colombia,  had  an  initial  malaria 
rate  of  1  500  per  1 000  employees*  and  found  that  the  first  invest- 
ment required  was  safeguarding  the  health  of  its  employees: 

In  Florida,  our  greatest  economic  handicap  is  the  health  condition 
in  our  rural  communities,  as  a  result  of  the  prevalence  of  hookworm 
and  malaria.  During  1 929,  a  total  of  470  deaths  from  malaria  was 
reported  which,  on  the  basis  of  average  severity  of  this  disease  in 
the  Florida  latitude,  would  indicate  that  there  were  approximately 
94,000  clinical  cases,  representing  a  financial  loss  from  sickness,  from 
this  one  disease  alone,  of  not  less  than  $500,000.00.  This  does  not 
take  into  consideration  the  lowered  production  and  the  interference 
with  raising  crops  and  other  activities  which  this  sickness  has  caused. 
We  have  also  a  prevalence  of  hookworm  disease  which  among  groups 
examined  runs  from  25%  to  80%  of  those  examined. 

Recently,  in  a  discussion  of  sickness,  one  of  the  leading  bankers 
estimated  that  the  cost  of  preventable  sickness  in  the  state  amounted 
to  approximately  $15,000,000.00  or  the  equivalent  of  a  30  mill  tax. 
The  state  at  the  present  time  provides  J/2  rnill  for  the  entire  health 
program  within  the  state  which  does  not  appear  to  be  an  appropriate 
investment  when  one  considers  what  preventable  illness  is  costing. 
The  most  effective  manner  of  combating  the  poor  health  conditions 
throughout  the  rural  communities  consists  in  carrying  the  health  activity 
directly  to  the  people  affected,  namely,  the  farmer,  and  it  appears 
that  the  full-time  county  health  unit  most  nearly  offers  the  solution 
for  this  condition.  A  certain  amount  of  legislation  will  be  necessary 
to  enable  the  health  department  to  give  the  relief  required  to  those 
who  are  sick  from  preventable  diseases.  This  requires  an  enabling 
act  authorizing  counties  to  appropriate  money  for  health  work  within 
the  county  and  also  an  act  which  authorizes  the  State  Board  of  Health 
to  receive  outside  funds  which  will  be  made  available  to  supplement 
the  cost  of  the  rural  health  program. 

The  object  of  the  program  outlined  is  to  convert  the  farmer 
from  his  present  condition  of  being  virtually  a  non-producer  of  taxes 
to  a  tax  producer  with  increased  earning  capacity  and  spending 
power. 

This  discussion  is  intended  to  point  out  more  effective  means 
of  state  economies  than  simply  slashing  certain  salaries  regardless  of 
merit.  It  is  not  intended  to  defend  useless  or  superfluous  positions 
but  it  is  hoped  that  careful  consideration  will  be  given  before  handi- 
capping those  who  are  rendering  effective  service  and  giving  value 
received. 


■The    1,500    case*    per    1,000    employee*    came    about    due    to    several    having    2    or    3 
attacks  during  same  year. 


FLORIDA   STATE   BOARD   OF   HEALTH [73 

CHILD    HYGIENE   AND   PUBLIC   HEALTH   NURSING 
Lucife   Spire   Blachly,   M.   D.,   Director 

THE   NEW   PROGRAM   IN  THE    FIELD 

As  announced  in  the  September  issue  of  Health  Notes,  the  new 
program  dates  from  the  first  day  of  that  month.  Preliminary  to  the 
introduction  of  the  Child  Hygiene  Week  Campaign,  a  part  of  the 
nursing  staff  was  detailed  to  make  county  social  assets  surveys  of 
their  respective  districts,  and  others  to  working  out  the  technique  of 
the  demonstrations,  exhibits,  and  child  health  conferences  which 
compose  the  Child  Hygiene  Week's  activities. 

Purpose  of  the  Surveys.  The  surveys  have  been  and  are  being 
made  to  introduce  the  new  program  and  to  ascertain  where  both  the 
need  and  the  realization  of  the  need  are  the  greatest.  To  date  the 
following  counties  have  been  surveyed:  Nassau  and  a  portion  of 
Duval  in  District  Number  One,  composed  of  Nassau,  Duval,  Clay, 
St.  Johns,  Putnam,  Flagler,  Marion  and  Volusia — nurse  for  this  Dis- 
trict,  Miss  Mary  G.   Dodd; 

Dade  and  Broward  in  District  Number  Two  composed  of  Semi- 
nole, Orange,  Brevard,  Osceola.  Indian  River,  Okeechobee,  St.  Lucie, 

Martin,  Palm  Beach,  Broward,  and  Dade nurse  for  this  District,  Miss 

Sarah  Ida  Richards; 

DeSoto  and  Charlotte  in  District  Number  Three  composed  of 
Polk,  Hardee,  Highlands,  DeSoto,  Charlotte,  Glades,  Lee,  Hendry, 
Collier,   Monroe — nurse  for  this  District,  Miss  Jule  0.  Graves: 

Baker,  Gilchrist,  Hamilton,  Columbia,  Suwannee  in  District 
Number  Five,  composed  of  these  counties  and  Union,  Bradford,  Ala- 
chua and  Levy; 

Wakulla,   Franklin  and  Leon  in  District  Number  Six  composed 

of    these   counties   and    Jefferson,    Madison,    LaFayette,    Dixie nurse 

for  this  District,  Mrs.  Thora  Roberts; 

Okaloosa  and  Santa  Rosa  in  District  Number  Eight  composed  of 
these  counties  and  Escambia,  Walton,  Washington  and  Bay — nurse 
for  this  District,  Miss  Nanna  Colby. 

Survey  work  has  not  started  in  District  Number  Four  composed 
of  Citrus,  Sumter,  Lake,  Hernando,  Pasco,  Pinellas,  Hillsboro. 
Manatee  and  Sarasota  Counties  as  the  nurse  for  this  District,  Miss 
Joyce  Ely,  has  been  working  out  the  details  of  the  demonstrations. 
She  has  been  assisted  by  Miss  Lai  la  Goggans. 

CHILD    HYGIENE    WEEK    IN    SOUTH    JACKSONVILLE 

Preliminary  to  Child  Hygiene  Week  in  South  Jacksonville,  car- 
ried out  on  joint  invitation  by  the  Woman's  Club  and  the  Parent- 
Teacher  Associations,  a  social  assets'  survey  was  made  by  Miss  Clio 
McLaughlin,  Chief  of  the  Bureau  of  Public  Health  Nursing,  and  Miss 


174 FLORIDA  STATE  BOARD   OF  HEALTH 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

Mary  G.  Dodd.      This  program  marked  the  introduction  of  the  cam- 
paign    to  the  state. 

On  October  2nd  and  3rd,  forty-seven  children  ranging  in  ages 
from  7  to  59  months  were  examined  by  Dr.  Lucile  Spire  Blachly  and 
Dr,  N.  J.  Phillips.  On  the  4th,  a  mothers'  meeting  was  held.  Miss 
Memphis  Wood,  instructor  in  art,  talked  on  "Art  and  Health;"  Mrs. 
Jessie  DeVore,  assistant  director  of  music,  on  "Music  and  Health"; 
and  Dr.  Blachly  on  "The  Need  of  Healthy  Mothers  and  Healthy 
Children".  Tea  was  served.  The  following  exhibits  were  put  on 
display:  books  for  parents  and  children;  toys  suitable  to  the  infant 
and  preschool  period;  tools  suitable  to  the  preschool,  school  and 
adolescent  ages;  maternity  and  infancy  equipment,  etc. 

On  Monday,  an  all  day's  Health  Institute  attended  by  thirty- 
two  delegates  from  as  many  organizations,  and  sub-organizations, 
was  held  with  the  following  program  given: 

8:45  -     9:00— Roll  Call. 

9:00    -      9:20 The    Program    of    the    Board    of    Health — Dr. 

Henry  Hanson,   State  Health  Officer. 
9:20   -      9:30 — Explanation   of   Exhibits — Miss   Goggans. 
9:30  -    10:00— Nutrition— Dr.  Blachly. 

10:00    -     10:15 Recess. 

10:15    -    10:35 — Demonstration Baby's  First  Foods — Miss  Ely. 

10:35    -    11:00 Character    Building    in    the    Preschool    Child — 

Dr.   Blachly. 

I  1  :Q0    -    1  1  ;30 Demonstration Baby's    Bath — Miss   Goggans. 

11:30-      2  :00 — Noon  Recess. 
2:00   -      2:30 — The   School   Child's   Health — Dr.   Blachly. 

2:30    -      2:45 Demonstration — The    Baby's   Bed — Miss    Ely. 

2  :45    -      3:1  0 — Demonstration — The      Confinement      Room — 

Dr.  Blachly. 
3:10   -      3:25 — Literature   from   the  State   Health   Department 
— Miss  Ely. 

3:25    -      3:40 Recess. 

3:40  -     4:00 — The  Health  of  the  Adolescent — Dr.   Blachly. 
4:00   -      4:30 — Demonstration — Baby's     Tray    and     Mother's 

Tray — Miss  Goggans. 
4:30    -      5:00 — Summing  Up — Dr.   Blachly. 

The  outstanding  feature  of  the  Child  Health  Conference,  as  shown 
by  an  analysis  of  the  physical  examination  records  of  the  children. 
■was  the  almost  total  neglect  on  the  part  of  the  parents  to  protect  the 
children  from  the  preventable,  communicable  diseases.  Of  the  forty- 
seven  children  examined,  only  three  had  had  toxin-antitoxin,  none 
had  been  vaccinated  against  smallpox,  none  had  been  tuberculin 
tested,  one  only  had  had  the  Schick  test  and  one  typhoid  vaccines. 
Four  had  had  no  orange  or  fruit  juices,  six  no  cereal,  eight  no  leafy 


. FLORIDA  STATE  BOARD   OF  HEALTH 173 

CHILD   HYGIENE  AND   PUBLIC   HEALTH   NURSING 

green  vegetables.      47%    had  been  nursed  up   to  the  seventh  month 
or  beyond. 

The  professional  work  involved  was  carried  on  by  all  the  mem- 
bers of  the  staff  of  the  Bureau,  assisted  by  Miss  Mary  Louise  Frazee, 
school  nurse,  and  Dr.  Phillips.  Dr.  Henry  Hanson  outlined  the  whole 
State  Board  of  Health  program  at  the  beginning  of  the  Health  In- 
stitute. 


BUREAU    OF   ENGINEERING 
Ellsworth  L.  Filby,  C.  E.,  Chief  Engineer 

REPORT  SNIPPINGS 

Here  and  there  among  the  prosaic  daily  reports  of  the  field 
staff  of  the  Bureau  of  Engineering  are  items  of  interest  such  as: 

Down  in  Tampa  recently,  Sanitary  Officer  Osborn,  in  investigat- 
ing a  typhoid  case,  discovered  that  the  sick  negro  was  a  "clay  eater  '. 
Clay  was  one  of  his  regular  items  of  food  and  until  September  last 
he  received  his  clay  via  parcel  post  from  Stockton,  Georgia.  Times 
got  hard,  remittances  back  to  Georgia  ceased  and  no  clay  was  forth- 
coming. A  local  supply  from  the  railroad-cut  nearby  was  developed. 
Alas: — Certain  privies  drained  into  the  cut,  railroad  wastes  were  de- 
posited therein,  rains  contaminated  the  food  supply  and  possibly  there 
was  a  typhoid  germ  or  so  left  on  the  clay. 

After  the  clay  eaters  came  "bat  roosts."  A  citizen  'phoned  ^e 
Tampa  office  that  a  vacant  house  had  become  a  bat  roost  and  it  was 
a  nuisance.      Call  the  Health  Department 

Over  at  Daytona  Beach,  one  small  child  discovered  a  monkey 
on  board  a  private  yacht.  Despite  a  sign  "Monkey  Bites"  the  child 
proceeded  to  investigate  and  the  youngster  went  home  crying  from 
being  bitten.  Possibly  with  visions  of  "mad  dog"  in  mind,  the  fond 
parent  complained  and  asked  the  city  manager  and  city  attorney  to 
have  the  animal  penned  up.  The  sign  plainly  stated  that  the  animal 
should  not  be  annoyed.  There  has  been  no  evidence  of  rabies  although 
five  days  have  elapsed  since  the  child  was  bitten.     Monkey  business  I 

Automobiles  influence  health?  Right.  But  when  they  have 
lived  their  day  and  are  piled  up  in  a  wrecking  or  junk  yard,  are  they 
a  health  menace?  Granted  their  presence  is  detrimental  to  property 
values,  no  one  can  get  them  removed — call  on  the  State  Health  De- 
partment! We  scramble  about  the  pile  but  find  no  evidence  of  the 
cars  holding  water,  thus  being  potential  mosquito  breeding  places. 
Our  regrets  to  the  complainant. 

Down  on  our  Gold  Coast,  between  Palm  and  Miami  Beaches, 


176 FLORIDA  STATE  BOARD  OF  HEALTH  

BUREAU    OF   ENGINEERING 

lives  a  winter  resident  from  up  north.  Adjoining  is  a  poorer  family 
who  balances  income  with  necessity  by  keeping  a  few  chickens.  Not 
being  scientific  poultrymen.  they  have  a  few  roosters  in  the  flock 
and  their  crowing  has  in  the  past  annoyed  our  winter  resident — in 
fact,  so  much  so  that  it  has  impaired  her  health  and  she  cannot  return 
next  winter  until  she  is  assured  by  the  State  Health  Department  that 
the  cocks  have  been  subdued.  Insinuation  is  made  that  the  cocks 
are  raised  for  gaining  purposes.  A  check-up  finds  no  sanitary  nui- 
sance, chicken  yard  in  excellent  sanitary  condition  and  prospects  of 
chicken  stew  this  ■winter  for  non-layers.  We  hope  our  winter  resident 
will  return. 

Newspaper  reports:  "Seminole  Indians  in  desperate  circumstan- 
ces out  in  the  Everglades.  Sanitation  very  bad  and  food  supply  deplet- 
ed," Sanitary  Officer  Renney  proceeded  to  Immokalee  and  found  that 
our  native  American  has  had  to  leave  his  good  hunting  ground  on  ac- 
count of  high  water.  Near  civilization,  of  course,  hunting  and  fishing  are 
not  so  good.  He  reports:  Money  is  scarce:  nothing  much  to  barter 
with,  and  roads  under  water  even  for  Model  T  open  cars;  usual  Indian 
cleanliness  (?)  about  the  camp ;  that  terrible  stench  which  comes  from 
"Kumpke."  a  root  which  is  ground  up  into  a  flour  and  then  baked  into 
a  bread ;  a  water  supply  from  a  very  shallow  well ;  no  method  of  waste 
disposal;  one  Indian  sick,  apparently  with  tuberculosis.  Explanations 
were  made  to  a  chief  who  understood  some  English  as  to  care  of  spu- 
tum and  wastes.  A  new  water  supply  was  located  for  their  use,  sus- 
pected case  reported  to  medical  department.  Modern  influences  were 
apparent:  Model  T  open  touring  cars,  canned  tomatoes,  white  bread, 
moonshine — civilizing  influences,  but  public  health  has  not  yet  made 
much  impression.     Hookworm,  however,  has.    A  problem,  indeed. 

Way  out  west,  as  it  were,  near  Pensacola,  Sanitary  Officer  Hobbs  > 
was  checking  school  sanitation  and  the  school  teacher  casually  re- 
marked that  she  wished  something  could  be  done  to  help  one  of  the 
children  who  apparently  was  broken  out  with  a  rash.  A  casual  in- 
quiry revealed  that  the  child  was  badly  bitten  by  mosquitoes.  An 
inspection  of  the  place  where  the  child  lived  revealed  it  to  be  a  hovel 
out  at  a  garbage  dump  maintained  by  a  private  garbage  disposal 
contractor.  The  family  pitted  their  intelligence  against  a  herd  of 
boys*  energy  in  securing  food  and  salvage  from  the  dump.  The  flies 
and  mosquitoes  were  so  numerous,  their  hum  rivaled  the  drove  of 
Navy  training  planes  above.  But  the  hum  of  Inspector  Hobbs*  motor 
soon  droned  into  the  distance  and  action  was  started  to  properly  care 
for  the  family  and  to  put  the  dump  into  decent  shape,  to  control 
fly  and  mosquito  breeding  and  to  prevent  the  salvage  of  foodstuffs 
for  human  consumption  from  the  dump. 

Millions  of  mosquitoes — literally  covering  the  bushes  and  break- 
ing them  down — running  stock  crazy,  people  unable  to  stay  in  their 
houses,  and  the  Paris  green  dusting  program  advocated  by  the  State 
Board  of  Health  killing  fish  by  thousands  instead  of  the  mosquitoes t 
An  official  inspection  requested.     Three  days  spent  on  Lake  Talquin 


FLORIDA   STATE   BOARD   OF   HEALTH t?7 

BUREAU   OF   ENGINEERING 

with  hundreds  of  dips  for  larvae  and  only  a  few  found — two  dead 
gar  fish  and  one  dead  alligator  found  through  aid  of  the  buzzards. 
Unofficially,  one  fish  trap  was  found  with  some  frying  size  fish 
therein — alive  and  kicking  although  they  were  just  under  the  surface 
which  had  been  dusted  with  1 0  %  Paris  green  mixture  a  few  days 
previously.  And  the  mosquitoes!  A  flash  light — daylight  inspection 
of  the  home  most  complained  of  revealed  no  adults  resting  therein. 
The  bushes  were  alive  with  midges — very  much  like  the  mosquito  but 
which  when  they  rest  on  your  body  do  not  bite — casual  demonstra- 
tion to  the  complainant  and   the  drinks   (soft)   were  on  him! 

These  experiences  and  others  are  all  in  the  day's  ■work  of  inspec- 
tions, checking  and  studying  our  problems — to  make  Florida  a  better, 

safer,  more  prosperous  place  to  live  in a  place  where  we  can  live 

longer  and  more  useful  lives,  where  we  can  fulfill  our  destiny  of  mak- 
ing the  land  a  better  place  in  which  to  live.  Florida — the  Land  of 
Sunshine  and  Eternal  Youth! 

BUREAU    OF    DIAGNOSTIC    LABORATORIES 
Paul  Eaton,  M.  D„  D.  P.  HL,  Director 

THE   PLACE   OF  THE   LABORATORY    IN    MEDICINE 

In  the  library  of  the  State  Board  of  Health  there  is  a  little  book 
entitled  "Medical  Thermometry  and  Human  Temperature".  It  was 
published  in  1872,  for  the  purpose  of  inducing  physicians  to  use  the 
thermometer  in  finding  out  whether  or  not  their  patients  had  fever. 
Up  to  that  time,  and  indeed  for  several  years  more,  it  was  the  general 
habit  of  physicians  to  judge  the  degree  of  fever  by  the  sense  of  touch. 

It  is  both  amusing  and  pathetic  that  for  many  years  after  the 
introduction  of  the  thermometer  there  were  physicians  who  claimed 
that  the  thermometer  was  less  accurate  than  the  hand  of  the  educated 
physician,  that  it  gave  fallacious  reports.  It  is  not  hard  to  see  how 
this  came  about.  Through  years  of  training  and  experience,  they 
had  become  accustomed  to  judge  a  patient's  condition  by  his  general 
appearance  as  well  as  by  the  sensation  perceived  from  his  skin.  We 
know  that  the  temperature  is  not  always  consistent  with  the  gravity 
of  the  patient's  condition  but  those  early  doubters  were  asking  the 
thermometer  to  do  what  only  they  could  do,  that  is,  add  up  all  the 
obtainable  facts  and  make  a  diagnosis.  We  know  that  the  reading  of 
the  thermometer  so  far  as  it  goes  is  much  more  accurate  than  is  the 
sense  perception  of  temperature  and  we  smile  at  the  old  physicians 
who  doubted  its  accuracy. 

In  the  years  that  have  elapsed  since  that  little  book  was  pub- 
lished, a  vast  number  of  physical,  chemical  and  bacteriological 
methods  have  been  applied  to  the  diagnosis  of  disease.  These 
methods  are  lumped  together  and  spoken  of  as  laboratory  methods. 
No  one  person  could  be  familiar  with  all  of  them  but  practically  all 
physicians  make  use  of  some  of  them  more  or  less  frequently.     The 


178 


FLORIDA   STATE  BOARD    OF   HEALTH 


BUREAU    OF    DIAGNOSTIC    LABORATORIES 

more  careful  the  physician,  the  more  frequent  the  use  of  laboratory 
methods,  but  always  with  the  understanding  that,  like  thermome- 
try, they  merely  add  accuracy  to  the  measurement  of  physical,  chemi- 
cal, or  biological  phenomena,  and  never  supplant  the  trained  clinical 
judgment  of  the  physician.  This  last  phrase  should  have  been  written 
"clinically  trained  judgment,"  because  the  word  "clinic"  bears  refer- 
ence to  the  bedside,  and  bedside  (or  office  chair)  observation  of 
the  patient  is  the  only  means  by  which  the  physician  may  develop  the 
judgment  which  enables  him  to  use  in  a  proper  way,  the  results  of 
laboratory  tests  in  diagnosis. 

The  little  book  referred  to  above  bears  on  its  fly  leaf  the  name 
of  Joseph  Y.  Porter,  Fort  Jefferson,  Florida,  and  the  date  December 
14,  1872.  I  mention  this  to  show  how  prompt  the  first  Health  Offi- 
cer of  Florida  was  to  avail  himself  of  new  knowledge.  As  late  as 
1884  there  were  plenty  of  physicians  who  "did  not  have  any  confi- 
dence in  the  thermometer." 


SUMMARY  OF  WORK  DONE  IN  AUGUST.  1 930 

Jacksonville      Tampa      Pensacala      Miami      Tallahassee      Tstal 


Animal   Parasites   

909 

267 

40 

200 

59 

1475 

Diphtheria      

416 

89 

14 

79 

29 

677 

Typhoid 

377 

212 

69 

8! 

68 

807 

Malaria       

558 

279 

62 

16 

162 

1077 

Rabies       „   „ , 

17 

2 

1 

20 

Tuberculosis     

187 

79 

7 

37 

12 

322 

Gonorrhea _ 

383 

187 

44 

90 

33 

737 

Kahn      _       

3689 

1089 

592 

5370 

Water :  Count  

57 

103 

3 

163 

Water:  Colon 

103 

2 

105 

Milk:  Bacterial  Exam.   ... 

80 

206 

200 

39 

525 

Milk:  Chemical  Exam.  ... 

135 

221 

280 

30 

666 

Miscellaneous        ..„  . 

173 

51 

14 

114 

19 

371 

6924  2739   251   1895   456  12265 


Specimen  Containers  Distributed  

Biological   Products  Distributed 


4721 


Diphtheria  Antitoxin 


Toxin  Antitoxin 
Schick  „ 


10,000   units 
5,000   units 


Tetanus  Antitoxin -„      20,000   units 

10,000    units 


4  7  Packages 

33  Packages 

1488  C.  C. 

404  Tests 

4  Packages 

4  Packages 


1,500   units       1013   Packages 


FLORIDA   STATE   BOARD   OF   HEALTH 


179 


BUREAU    OF    DIAGNOSTIC    LABORATORIES 


Typhoid  Vaccine  

Vaccine  Virus „...„. 

Antirabic  Virus  - 

Anaerobic  Virus 

Carbon  Tetrachloride 


100 


c.  c. 


577   Treatments 
692    Capillaries 
1  8   Treatments 
9   Packages 
781    Capsules 


SUMMARY  OF  WORK  DONE  IN  SEPTEMBER   1930 


Jacksonville 

Animal  Parasites  1 1 08 


Diphtheria    ., 

Typhoid  

Malaria    

Rabies    

Tuberculosis 


663 
413 
551 
13 
177 


Gonorrhea  ......     499 


Kahn    

Water:   Count 
Water:   Colon 
Milk:  Bacterial 
Milk:  Chemical 
Miscellaneous  ... 


Exam.- 
Exam. 


3781 


68 
111 
203 


Tampa      Pensacola      Miami      Tallahassee      Total 


300 

117 

205 

244 

1 

60 

184 

1088 

36 

214 

277 
■54 


55 
10 
59 
59 
1 
12 
36 
12 


136 

143 

14 


208 

283 

52 

24 

2 

48 

99 

631 

133 

133 

261 

139 

155 


28 
30 
72 
98 

6 
32 


44 

17 

7 


1699 

1103 

801 

976 

17 

303 

850 

5512 

169 

133 

723 

687 

433 


7587  2780   537  2168   334  13406 


Specimen  Containers  Distributed 


7371 


Biological  Products  Distributed 


Diphtheria  Antitoxin.. 

Toxin  Antitoxin 

Schick _ 

Toxoid.. 

Tetanus  Antitoxin.. 


Typhoid  Vaccine.. 

Vaccine  Virus 

Antirabic  Virus... 
Anaerobic  Virus.. 


Carbon  Tetrachloride,. 


10,000    units 
5,000  units 


20,000    units 

10,000   units 

1,500    units 


1  00  c.  c. 
10   c.  c. 


88  Packages 
23   Packages 
5,135   C.  C. 
4,365   Tests 
1,680  C.  C. 

6   Packages 
3 1    Packages 
1,233    Packages 

1.498  Treatments 
2,112   Capillaries 
27   Treatments 
1    Package 
3    Packages 
6,547  Capsules 


ALL  REQUESTS  FOR  BIOLOGICS  SHOULD  BE  DIRECTED  TO 
THE  STATE  LABORATORY.  JACKSONVILLE,  FLORIDA. 


180 FLORIDA   STATE  BOARD  OF   HEALTH 

BUREAU    OF   COMMUNICABLE   DISEASES 
F.  A.  Brink,  M,  D.,  Director 

PREVENT   PELLAGRA 

For  the  seven  year  period  1  923  to  1929,  inclusive,  there  was  a 
continuous  trend  upward  in  the  number  of  deaths  per  annum  from 
pellagra  in  Florida.  The  number  of  deaths  reported  during  the  first 
eight  months  of  1  930  was  decidedly  lower  than  for  the  same  period 
in   1929. 

Whether  there  is  to  be  an  increase  or  decrease  next  year  will 
depend  entirely  upon  the  people  and  largely  upon  the  breadwinners. 
We  are  wont  to  speak  of  the  man  who  "brings  home  the  bacon". 
There  has  been  too  much  bacon,  self-rising  flour,  corn  meal,  syrup 
and  grits  in  our  diet.  If  we  want  to  be  well  and  see  our  children 
develop  normally,  we  should  talk  about  bringing  home  the  milk,  but- 
ter, eggs,  fresh  lean  meat,  poultry,  fish,  fruit  and  vegetables  for  these 
are  the  pellagra -pre  venting  foods.  If  every  family  had  a  cow,  a  gar- 
den and  chickens,   there  would  be  little  need  to  discuss  this  subject. 

An  Economic  Problem 

In  many  a  rural  home,  pellagra  has  made  its  appearance  after 
the  farmer  has  quit  the  field  to  make  his  living  on  the  road  or  at  the 
mill;  its  prevalence  increases  with  the  advent  of  economic  depres- 
sion. These  facts  coincide  with  the  other  evidence  pointing  to  de- 
ficiency of  diet  as  the  cause.  Definite  information  about  the  kind  of 
diet  that  is  necessary  to  prevent  and  to  cure  must  be  carried  to  all  the 
people.  This  is  a  medical  problem  and  every  practicing  physician 
has  a  responsibility.  It  is  his  duty  to  join  forces  with  the  health 
authorities,  nutritionists  and  agriculturists  in  promoting  those  well 
known  dietetic  measures  that  will  prevent  pellagra  and  at  the  same 
time  improve  the  economic  situation.  Without  any  increased  income, 
many  families  can  greatly  improve  their  table  by  judicious  spending. 
To  accomplish  this,  however,  some  will  have  to  learn  to  place  health 
in  a  place  of  greater  importance  than  soda  water,  chewing  gum,  cos- 
metics— greater  even  than  the  petrol  wagon  and  that  which  maketh 
the  same  to  go. 

The  future  growth  of  Florida  must  go  hand  in  hand  with  the 
development  of  agriculture,   our  most  important  industry. 

The  eradication  of  malaria  and  hookworm  will  aid  greatly  in 
preventing  pellagra.  We  do  not  know  all  about  pellagra.  Appar- 
ently, it  is  not  "catching",  is  not  transmitted  and  isolation  of  patients 
does  not  prevent.  There  may  be  other  factors  involved  besides  de- 
ficiency of  diet  but  it  has  been  proven  that  food  and  food  alone  will 
accomplish  its  removal.  Every  man,  therefore,  should  take  sufficient 
interest  in  bis  own  continued  freedom  from  disease  to  learn  the  rudi- 
ments of  proper  eating  and  to  provide  for  himself  and  eat  the  foods 
that  will  protect  him.     Tomato  juice  is  rich  in  the  pellagra-preventing 


FLORIDA  STATE  BOARD  OF  HEALTH 1&1 

BUREAU  OF  COMMUNICABLE  DISEASES 

principle.     Dried  yeast  is  also  of  value  as  an  adjunct  to  other  foods 
but  must  never  be  used  to  the  exclusion  of  a  proper,  balanced  diet. 

The  Early  Signs 

The  most  constant  and  usually  the  earliest  sign  of  pellagra  is  an 
eruption  which  resembles  sunburn.  It  appears  on  the  hands  and  fore- 
arms, feet  and  legs,  neck  and  face.  It  persists  and  the  reddened  skin 
turns  to  a  dirty  brown,  often  becoming  parchment-like  and  scaly. 
These  changes  may  be  associated  with,  followed  or  preceded  by  weak- 
ness, nervousness  and  indigestion.  Recurrence  is  frequent  and  is  often 
due  to  falling  back  to  the  old  eating  habits. 

For  anyone  who  suspects  the  presence  of  any  sign  of  pellagra 
the  best  advice  the  State  Board  of  Health  can  give  is  to  consult  a 
medical  doctor  without  delay. 

The  State  Board  of  Health  has  a  limited  supply  of  dried  yeast 
in  two-pound  packages  that  will  be  sent  free  to  physicians  for  indi- 
gent pellagra  patients. 

INFANTILE    PARALYSIS 

Ten  cases  of  infantile  paralysis,  (acute  anterior  poliomyelitis) 
have  been  reported  to  the  State  Board  of  Health  from  January  1st 
to  October  18th,  1930.  The  number  of  cases  reported  during  the 
previous  four  years  was  as  follows:  1929 — 33;  1928^23;  1927 — 
39;  1926—16. 

Only  once  during  this  period  has  there  been  anything  approach- 
ing an  epidemic  and  on  this  occasion  there  were  1  3  cases  and  one 
death  in  a  city  of  about  6,000  population.  This  was  in  April  and 
May.   1929. 

Infantile  paralysis  always  causes  anxiety  to  the  parents  of  young 
children.  Though  nearly  all  cases  appear  singly  and  the  infection 
does  not  spread,  it  is  wise  at  all  times  to  know  and  observe  the 
hygienic  measures  that  will  afford  protection  from  this  and  other 
infectious   diseases. 

Preventive  Measures 

1 .  Cover  the  face  with  a  handkerchief  or  the  hand  when  you 
cough  or  sneeze.  Avoid  persons  who  neglect  to  do  so. 
Avoid  loud  talking  and  spitting. 

2.  Wash  the  hands  frequently,  especially  before  eating.  Keep 
unclean  articles  and  fingers  away  from  the  mouth  and  nose. 

3.  Avoid  common  drinking  cups,  eating  utensils,  pencils, 
towels,   basins,    toilet  articles. 

4.  Avoid  exposure,   fatigue,  dissipation. 

IN  CASE  OF  ANY  SICKNESS  isolate  the  patient,  put  him  to 
bed  and  call  a  medical  doctor. 


182 


FLORIDA   STATE   BOARD   OF   HEALTH 


TEC  OB  OS 


BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

INFANT  MORTALITY  LOWER  IN  I 929 

The  American  Child  Health  Association  has  recently 
published  its  annual  compilation  of  infant  mortality 
rates  in  729  cities  of  the  United  States  for  the  year 
1 929.  We  quote  from  the  Child  Health  Bulletin  for 
September: 

"The  death  rate  among  babies  in  720  cities  of  the  Birth  Regis- 
tration Area  was  about  two  points  lower  than  in  the  preceding  year, 
the  rate  for  1929  being  66,2  as  against  68.3  for  1928.  These  rates 
represent  the  number  of  deaths  among  children  under  one  year  of 
age  for  each  thousand  live  births.  The  1  929  rate  is  thus  the  second 
lowest  rate  on  record  for  the  cities  of  the  country,  the  1 92  7  rate  of 
64.9  being  the  lowest  reported." 


-  LP  R  I  DA 


The  following  tables  indicate  the  number  of  deaths  from  certain 
diseases  by  months,  for  1930  as  compared  with  the  previous  year. 
(Provisional  figures.) 

TYPHOID  DEATHS 


Year          fen. 

Feb. 

Mar.   Apr.   May  June  July  Aug. 

Total 

Sept.    Oct.    Nov.    Dec. 

Total 

1930    10 
1929      2 

5 
4 

5  3      5      8      6      7 

6  1!      8    11    13      7 

49 
62 

4      6      5      6 

83 

MALARIA  DEATHS 

Year         Jan,      Feb.      Mar.   Apr.   May  June  July  Aug.      Total      Sept,   Oct.   Nov.    Dec.        Total 


1930  17   16  14  19  15  20  39  38 
1929  24   7   15  14  30  40  65  59 


178 
254 


72  71  40  33 


470 


DIPHTHERIA   DEATHS 

Year         Jan,      Feb.     Mar,  Apr,  May  Junejuly  Aug,      Total      Sept.  Oct,  Nov.  Dec        Total 


1930 
1929 

6 
8 

6 
6 

4     3      3      5      2     4 
3     3      3      1      18 

33 
33 

10     6     6 

12 

67 

Year 

Jan. 

Feb. 

TUBERCULOSIS  DEATHS 

Mar.   Apr.   May  June  July  Aug.      Total      Sept.   Od.    Nov, 

Dec. 

Total 

1930 
1929 

84 
81 

89 
109 

101    94  92   74   85    71    1 690 

88  85   81    76  88  82   |  690 

71    80  87 

66 

1014 

FLORIDA   STATE  BOARD   OF   HEALTH 


183 


BUREAU  OF  VITAL  STATISTICS 

PROVISIONAL  MORTALITY  FOR   AUGUST.  *1930 
AS    COMPARED   WITH    SAME    PERIOD    PREVIOUS    YEAR 


Inter- 

national 
List  No. 
(1929) 


FLORIDA 


Total  |  iVhite  [   Col,   I 


NUMBER    OF    DEATHS 


August,     1930      | 


August,     1929 


Total 


White    Col. 


GENERAL  MORTALITY   (ALL  ACES) 


1-200 


1-2 

6 
7 
8 
9 
10 

'1  I 
16 
17 
16 
23-32 
38 

45-53 
62 
59 

78-89 

82 

90-103 

90-95 

104-1  14 
107-109 
1 15-129 
119 
130-139 
130-132 
140-150 


ALL  CAUSES 


1292 


Typhoid    _ 

Smallpox     _.., 

Measles   

Scarlet   fever  * «. 

Whooping   cough 
Diphtheria     - _ 


Influenza „__, 

Acute    anterior   poliomyelitis 

Lethargic    encephalitis    

Meningococcus   meningitis  

Tuberculosis all     forms     _ 

Ma  la  ria    


Cancer — all    forms 
Pellagra 


Diabetes    mellitus 

Diseases    of  the    nervous    system   

Cerebral   hemorrhage,    apoplexy   . 
Diseases    of    the    circulatory    system 

Diseases   of    the    heart    __ _. 


Diseases    of    the    respiratory    system 
Pneumonia—all    forms     


Diseases    of    the    digestive    system „... 

Diarrhea  and  enteritis  (under  2  years)  . 
Non venereal   diseases   genitourinary  system. 

Nephritis all    forms 

The    puerperal    state    „_,.__„_ 


7 
4 

10 
2 

2 

78 
42 

70 
20 
12 
142 
105 
188 
170 

66 

50 
106 

19 
141 
120 

19 


737 


3 

3 

4 
2 

2 

24 

22 

54 
4 

10 

85 

67 

136 

125 

36 

28 
58 
6 
82 
75 
I  I 


555 


54 

20 

16 
16 
2 
57 
38 
52 
45 

30 
22 
46 
13 
59 
45 
8 


1333 


82 
59 

82 
19 
17 
169 
I  12 
180 
162 

51 

40 
107 

16 
164 

135 
35 


768 


I 
32 
31 

68 
4 

10 
95 

61 
126 
112 

25 

16 
55 
10 
96 
77 
23 


INFANT  MORTALITY 

Number  of  LIVE  BIRTHS 

Number  of  STILLBIRTHS 

Number    of    DEATHS    under     I     year     (all    causes) 


By  cause:    (deaths  under 

l-44.exe.    11.   23.    32a 

II,  23.    32a,    104-114 

I  18,    119 

157-161 

159 

160 


I    year) 

Infectious    diseases 

Respiratory   diseases  .,,,, 

Castro-intestinal    diseases    - 
Malformations    &    early   inf. 

Premature    birth    

Injury  at    birth 


2337 

1578 

759 

2305 

154 

67 

87 

140 

150 

79 

71 

131 

12 

5 

7 

6 

25 

15 

to 

9 

15 

5 

10 

9 

71 

47 

24 

63 

37 

24 

13 

50 

3 

1 

2 

9 

566 
59 
71 


4 
3 
4 
49 
29 
6 


Includes  delayed   certificates. 


184 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  AS5ET 


American  Junior  Red  Cross 


L-— t— »j«                     i-«  ■-                     rmmmn*                      urn*                  »wt> 
JUNIORS    HELPING    EVERYWHERE 
~ .  — — — — ■ 


This  Issue  Exceeds  i  2,000  Copies 


pUORlD^ 


AlTH  NOT 


OFFICIAL    MONTHLY    BULLETIN 

ESTABLISHED    JULY,    1892 

STATE  BOARD  OF  HEALTH 

JACKSONVILLE,  FLORIDA 

Entered  a>  Second  Clan   Milter,  October  27,    HZ  I 
■t  the   Pot  toff  ice  at   Jacksonville,    Florida.   Under   the  Act    of   Anautl    1*.    1912 

Thia  Bulletin  will  be  sent  to  any  addreai  in  the  State  free  of  charge. 

Vol.  22  DECEMBER,    1930  No.  12 


Edited    by 

STEWART  G.  THOMPSON.  D.P.H.,  M™b«r 

American    Medical   Editori'  and   Anthora'   Ai»n. 


SPECIAL  ARTICLES 

ANOTHER  WAR?  —  Brink 

LABORATORY  AID  —  Eaton 

TUBERCULOSIS  AND  HOPE  —  Hanson 

TUBERCULOSIS  —  ALL  AGES  —   Thompson 

TUBERCULOSIS   AND   MATERNITY   —   BJachly 


HENRY  HANSON.  M.  D..  STATE  HEALTH  OFFICER 


186 


FLORIDA   STATE   BOARD   OF   HEALTH 


BOARD    MEMBERS 


H.    Mason    Smith,    M. 
Tampa 


Pros. 


Henry     E.     Palmer, 
Tallahassee 


M.    D. 


Edward    M.     L'Engle,    M.    D 
Jacksonville 


STATE   HEALTH    OFFICER 

Henry     Hanson.     M.     D. 


BUREAUS   AT  JACKSONVILLE 


Diagnostic     Laboratories.. 
*  Vital    Stntifttica 


Communicable    Di*ea*ea_ 
Engmwrmg.. 


Child   Hygiene   and   Public  Health    Nursings 
Accounting- 


Crippled    Children., 


DIRECTORS 

Paul   Eaton,   M.   D„    D.    P.   H. 
Stewart  C.   Thompson,  D.   P.   H. 
F.   A.   Brink.   M.    D. 
Ellsworth   L.  Filby,  C.  E. 
Luetic   Spire    Blachly.    M.    D, 
Screven    Dozier 
F.   L.   Fori,  M.  D. 


*550    Local    Registrars    (County    list    furnished    on    request). 

'Registration   inspector , Anna   C*   Emmons 

Drug    Store    Inspector H.   R.   Monroe 


LABORATORIES 


Jacksonville  .. 
Miami 

Pen  sa  cola 

Tallahassee 

Tampa- 


Pearl  Griffith.   B.    E. 
E.   R.    Powell 
Johneite  McCormick 
Jane  B-   Currie,   H.  S. 
H.    D.  Venters,   B.   S. 


MEDICAL    OFFICERS 


DeFuniak    Springs- 
lacks  on  vi  Lie 

Vero    Bead) 

Ta  1 1  a  h  a  a  see ___ ^. 

Tampa.. 


B rooks ville  . 


C,   W.    McDonald.   M.   D. 

B.  C.    Wilson.  M.    D. 
W.  A.  Claxton.  M.  D. 
H.    A.   McCture,    M.    D. 

C.  W.   Pease,  M.  D, 
A.  C.  Hamblin,  M.  D. 


Jacksonville- 
Jacksonville... 
Mi«mj 
Ocala 


DISTRICT  SANITARY    OFFICERS 


Orlando 

Pun  la     Gorda ... 
Tallahassee.......... 

Tmrnpn 


V-   8.    Umoureux,    C-    E- 
Fred   A*    5a fay 
George    B.    Reed 

C.  A.    Holloway 
Russell     Rroughman 
C    -\.   Renney 

C   N.   Hobbn 

D.  H.    Osburn 


Jacksonville 
Arcadia... 


PUBLIC   HEALTH   NURSES 


DeFuniak   Springs 

Eden,   R.    F.  D.  Jensen- 
Lake    City 

Maria  naa ■ 

Ruskirs 

5 1  a  rke 


Clio   McLaughlin,   R.   N. 
Jule    Craves,   R.    N. 
Nanna  Colby,   R.  N. 
Sarah    Ida    Richards,    R.    N, 
Frances  Hall,   R.   N. 
Latla   Mary  Goggans,  R.  N. 
Joyce  Ely,   R.   N. 
Mary   G.    Dodd,   R.   N. 


Jacksonville- 


COUNTY   HEALTH   UNITS 

E.  C.  Stoy   (U.  3.   P.   H.  S.> 


FLORIDA   STATE   BOARD   OF   HEALTH I B7 

ADMINISTRATION 
Henry  Hanson,  M.  D.,  State  Health  Officer 

TUBERCULOSIS  AND  HOPE 

In  attempting  an  article  on  tuberculosis  one  hesi- 
tates; the  subject  is  so  old  that  there  appears  to  be 
nothing  new  to  say.  Still,  there  is  new  hope  every 
day.  both  in  avoiding  the  disease  and  in  its  arrest 
and  cure. 


What  we  are  most  interested  in  is  prevention. 
Those  of  you  who  have  your  regular  periodic  exam- 
ination (this  should  be  complete  when  your  doctor 
will  strip  you  and  look  you  over  from  head  to  foot) 
will  find  out  if  you  have  an  early  lesion,  (a  beginning  of  the  disease 
in  some  part  of  your  body)  which  if  treated  promptly  and  right  can 
be  stopped. 

Most  persons  who  find  their  tuberculosis  early  can  be  cured.  Such 
persons  are  of  practically  no  danger  to  their  associates,  as  far  as  trans- 
mitting the  infection  is  concerned,  and  they  have  a  well-founded  hope 
of  a  cure. 

Most  individuals  who  have  tuberculosis  have  contracted  the  in- 
fection during  childhood  and  have  knowingly  or  unknowingly  carried 
on  struggles  -with  the  disease  in  which  the  conflict  has  fluctuated, 
sometimes  the  tuberculosis  gaining  and  again  the  resisting  powers  of 
the  individual.  These  patients  (sick  people)  have  a  hopeful  fu- 
ture if  they  place  themselves  in  the  care  of  their  best  friend,  the  family 
physician,  and  follow  his  instructions.  The  family  doctor  really  does 
know  more  about  the  care  of  sickness,  and  the  ailments  of  the  human 
body  than  a  neighbor  friend  or  some  relative  who  never  has  stud- 
ied things  of  this  kind. 

Probably  eighty-five  per  cent  of  the  doctors  practicing  medicine 
have  been  in  college  before  entering  medical  school  and  while  there 
they  studied  chemistry,  physics,  biology,  etc.,  before  taking  up  medi- 
cal studies.  During  these  studies,  about  two  years  are  spent  in  analyz- 
ing the  construction  of  the  body  and  when  the  student  finishes,  he  not 
only  knows  what  each  organ  in  the  body  looks  like,  but  knows  its 
correct  position,  the  way  it  receives  and  discharges  its  blood  supply; 
also,  what  each  microscopically  minute  cell  (of  which  the  different 
parts  of  the  body  are  made  up)  look  like.  These  men  who  came 
from  good  schools  can  tell  if  you  are  in  good  physical  condition. 
Listen  to  them  and  don't  waste  your  time,  money  and  hope  on  peo- 
ple who  tell  you  that  your  vertebrae  are  out  of  place  or  that  a  nerve 
is  being  pinched  or  other  claims  which  cannot  be  proven  either  by 
X-ray  or  legitimate  laboratory  tests. 

The  greatest  menace  in  the  spread  of  tuberculosis  from  one  indi- 
vidual to  another  is  the  advanced  pauper  patient  who  has  reached  a 
stage  of  hopelessness,  when  by  reason  of  this  stage  he  is  careless  with 


188 


FLORIDA   STATE  BOARD  OF   HEALTH 


ADMINISTRATION 

his  sputum.  He  expectorates  on  the  floor  where  children  play  and  pick 
up  the  germs  in  various  ways.  There  is  very  little  chance  that  chil- 
dren in  such  families  will  escape  infection.  Cases  of  this  type  should 
be  isolated  as  a  precaution  as  much  as  a  case  of  smallpox,  diphtheria 
or  scarlet  fever.  The  open,  advanced  tuberculosis  case  is  more  dan- 
gerous to  the  public  than  the  ordinary  communicable  diseases  men- 
tioned above. 

BUREAU  OF  COMMUNICABLE  DISEASES 
F.  A.  Brink,  M.  D.,  Director 

ANOTHER  WAR? 

Our  hearts  swell  with  pride  when  we  contemplate 
our  victories  in  war  and  we  rejoice  to  honor  our 
heroes  of  the  battlefield.  Likewise,  we  glory  in  the 
conquests  of  disease  and  exalt  the  victors  in  the  hard 
fought  battles  against  pestilence. 

Because  of  the  opportunity  offered  every  cit- 
izen, great  and  small,  to  participate,  the  war  against 
tuberculosis  has  a  special  place  in  our  thoughts  at 
this  season. 

Apparently,  yellow  fever  in  the  United  States  is  only  a  memory. 
From  a  number  of  states  where  malaria  once  prevailed  it  has  now  been 
driven  out.  Hookworm  disease  in  the  south  is  being  conquered  through 
sanitation,  although  much  remains  to  be  done  in  the  way  of  education 
and  stimulation  to  action.  Parents  must  realize  that  the  child's  bill  of 
rights  includes  protection  from  all  avoidable  health  hazards. 

The  war  against  the  great  white  plague,  tuberculosis,  should  be 
waged  with  greater  vigor.  The  enemy  Is  weakening.  It  may  well  be 
that  with  increasing  momentum  this  war  will  be  prosecuted  to  a  com- 
plete victory  sooner  than  any  of  us  now  dare  hope.  Certainly,  this 
happy  culmination  'will  come  the  sooner  if  all  our  forces,*  all  our  re- 
sources are  combined  to  that  end,  just  as  was  done  in  another  great 
war  of  recent  memory.  We  must  overcome  indolence  of  mind  and 
body.  Our  efforts  must  be  wisely  and  continuously  directed  toward 
production  and  distribution  of  the  necessities  and  the  comforts  of  life. 
The  wealth  of  the  nation  should  provide  proper  food,  shelter  and  hy- 
gienic surroundings  for  every  citizen.  All  other  preventable  sickness 
should  be  eliminated.  Warfare  against  tuberculosis  is  more  indirect 
than  direct.  The  fight  must  be  directed  toward  the  general  upbuild- 
ing of  the  race  and  reduction  of  all  harmful  or  debilitating  influences. 

TUBERCULOSIS* 

While  tuberculosis  in  Florida  is  not  so  common  as  in  most  north- 
ern states,  it  is  still  an  important  factor  in  our  health  and  should  be 
thought  of  as  a  cause  of  protracted  illness. 

•Prepared   on    request    by    Dr.    W.    A.    Quton,    Field    Medical    Officer 


FLORIDA  STATE  BOARD  OF  HEALTH 189 

BUREAU  OF  COMMUNICABLE  DISEASES 

During  a  recent  series  of  clinics  there  were  found  in  one  town, 
out  of  1  13  people  examined,  I  4  cases  of  pulmonary  tuberculosis.  In 
another  town,  77  people  were  examined  and  1  1  were  found  to 
have  this  disease.  This  is  not  a  measure  of  the  number  of  people  in 
these  towns  who  had  tuberculosis.  It  is  an  indication  of  the  number 
who  had  the  good  sense  to  come  to  the  clinic  to  be  examined.  Flori- 
dians  are  fortunate  because  they  can  live  in  fresh  air  all  the  year  round. 
This  lessens  the  possibility  of  infecting  the  rest  of  the  family  and  the 
neighbors'  children  but  does  not  mean  that  precautions  against  the 
spread  of  the  disease  should  be  relaxed. 

Every  individual  in  Florida  today  who  has  tuberculosis  has  ac- 
quired it  through  the  ignorance  or  indifference  of  some  one  else.  Where 
a  diagnosis  is  made  early  such  restrictions  can  be  instituted  as  will  les- 
sen the  danger  of  the  spread  of  the  disease  and  give  the  person  affect- 
ed a  much  greater  chance  of  recovery.  The  disease  is  spread  princi- 
pally by  coughing  or  breathing  into  someone  else's  face.  This  is  an 
insanitary  and  disgusting  habit  at  best  and  when  the  "cough"  is  laden 
with  thousands  of  tuberculosis  germs,  it  is  dangerous  in  the  extreme. 

In  going  into  the  history  of  tuberculosis  patients,  we  learn  nearly 
always  that  in  their  childhood  they  lived  in  a  house  with  a  father, 
mother,  aunt,  servant  or  other  person  who  died  later  from  consump- 
tion. In  this  way,  whole  families  grow  up  and  become  victims  of  tu- 
berculosis. They  were  infected  by  carelessness  or  ignorance.  The 
closer  the  contact,  the  greater  the  liability  of  infection. 

The  remedy,  of  course,  is  for  the  person  with  tuberculosis  to  keep 
away  from  children,  to  have  a  room  to  himself,  to  hold  a  piece  of 
gauze  or  paper  handkerchief  over  his  mouth  when  he  coughs,  to  burn 
all  sputum  that  is  coughed  up  and  to  have  all  eating  utensils  boiled 
after  use. 

While  we  must  guard  with  all  our  resources  against  passing  the  dis- 
ease to  children,  we  must  remember  that  the  contacts  of  adults  with 
tuberculosis  patients  is  not  nearly  so  dangerous.  There  is  much  unneces- 
sary fear  in  this  regard.  Grown  men  and  women  have  come  to  me 
to  ask  anxiously  if  it  was  safe  to  live  in  the  same  apartment  building 
or  in  the  next  house  to  a  person  with  tuberculosis.  When  we  consider 
that  physicians  and  nurses  are  in  contact  with  tuberculosis  every  day 
in  sanatoria  and  that  a  wife  will  nurse  a  husband  for  months  or  years 
without  getting  the  disease,  we  should  show  less  alarm  when  we  come 
accidentally  in  contact  with  a  person  with  tuberculosis.  Keep  the 
children  away  by  all  means  but  do  not  unnecessarily  embarrass  the 
tuberculous  neighbor  by  shunning  him  when  there  is  practically  no 
danger  of  catching  the  disease.  Rather  go  in  and  talk  to  him  and 
brighten  him  up.     He  will  appreciate  it 

There  are  two  ways  by  which  the  spread  of  tuberculosis  can  be 
lessened:      ( 1  )  by  having  a  competent  county  health  unit  whereby  the 


190 FLORIDA  STATE   BOARD   OF   HEALTH 

BUREAU  OF  COMMUNICABLE  DISEASES 

people  with  tuberculosis  can  be  taught  to  lead  hygienic  lives  and  can 
be  prevented  from  infecting  their  children;  (2)  by  the  establishment 
of  a  state  sanatorium  where  people  -with  tuberculosis  can  go  and  be 
taught  how  to  live,  to  get  well  and  not  to  be  a  menace  to  the  younger 
members  of  the  household. 

Regrettable   Error 

The  death  of  a  number  of  children  at  Medellin,  Colombia,  due 
to  the  injection  of  diphtheria  toxin  instead  of  antitoxin  is  to  be  de- 
plored. Such  an  error  could  scarcely  be  made  by  anyone  experienced 
in  giving  these  treatments,  especially  since  the  toxin  and  toxin-antitoxin 
mixtures  are  put  up  in  packages  quite  different  from  those  containing 
antitoxin.  The  -widespread  publicity  given  the  incident  may  cause  un- 
necessary fear  of  all  preventive  and  curative  injections  and  result  even- 
tually in  even  a  larger  number  of  unnecessary  deaths.  We  must  not  for- 
get that  in  Florida  in  1 929,  there  were  67  diphtheria  deaths,  all  of 
which  could  have  been  prevented. 

BUREAU  OF  DIAGNOSTIC  LABORATORIES 

Paul  Eaton,  M.  D.,  D.  P.  H-,  Director 

LABORATORY  AID 

The  human  body  is  so  "fearfully  and  wonderfully 
made,"  that  the  diagnosis  of  diseased  conditions  is 
sometimes  so  difficult  r.s  to  be  impossible  during 
life.  (A  post  mortem  diagnosis,  "while  perhaps  in- 
teresting to  physicians,  is  the  absolute  zero  in  inter- 
est to  the  patient.) 

Diverse  causes  may  result  in  similar  signs,  symp- 
toms, and  lesions.  The  same  disease  may  present 
absolutely  dissimilar  changes  in  different  persons. 

It  is  one  of  the  triumphs  of  modern  medicine  that  physical,  chem- 
ical, and  biological  methods  have  been  developed,  which  in  certain  ob- 
scure cases,  enable  the  physician  to  assign  the  correct  exciting  cause 
out  of  a  number  of  possible  causes  to  a  diseased  condition. 

Perhaps  some  who  read  this  can  recall  the  excitement  that  was 
caused  by  the  announcement  in  1  88 1 ,  that  the  causative  organism  of 
tuberculosis  had  been  found. 

Tuberculosis  has  been  known  in  medical  literature,  since  the  time 
of  Hippocrates,  the  "Father  of  Medicine".  Many  diseases  with  sim- 
ilar signs  and  symptoms  have  been  confused  with  tuberculosis  and  a 
means  of  identifying  true  tuberculosis,  as  accurately  as  possible  was, 
and  is,  very  welcome. 

Robert  Koch  found  that  the  sputum  of  tuberculosis  patients  reg- 


FLORIDA   STATE   BOARD   OF   HEALTH I9J 

BUREAU  OF  DIAGNOSTIC  LABORATORIES 

ularly  contained  small  bodies  which  could  be  identified  by  their  be- 
havior in  the  presence  of  certain  chemicals.  His  original  method  of 
staining  the  bacillus  of  tuberculosis  was  soon  superseded  by  a  better 
one  which  is  still  in  use, 

A  specimen  of  sputum  is  spread  out  in  a  fairly  thick  layer  on  a 
glass  slide  and  made  to  adhere  to  the  slide  by  a  gentle  heating  which 
amounts  to  a  slight  cooking  of  the  albuminous  material  in  the  sputum. 

This  preparation  is  then  flooded  with  a  solution  containing  a 
brilliant  red  dye  and  carbolic  acid  and  kept  hot  enough  to  steam 
gently  for  about  three  minutes.  This  treatment  stains  everything  on 
the  slide  a  vivid  red.  After  the  surplus  dye  has  been  washed  off,  the 
preparation  is  treated  with  an  acid  solution  which  bleaches  the  red  out 
of  everything  on  the  slide  but  the  tubercle  bacilli.  These  may  be  rec- 
ognized under  very  high  magnification  as  tiny  red  threads  looking 
much  like  short  pieces  of  red  silk  thread. 

Koch  propounded  a  set  of  rules  for  establishing  the  causative  re- 
lation between  bacteria  and  disease. 

1 .  The  organism  causing  the  disease  must  be  recoverable  from 
every  case  of  the  disease. 

2.  It   must   be   capable   of   being    obtained  in    "pure   culture"; 
that  is,  in  a  culture  free  from  other  organisms. 

3.  This  pure  culture  must  be  capable  of  causing  the  disease  in 
question  in  animals  not  previously  suffering  from  it. 

4.  It  must  be  recoverable  in  pure  culture  from   these  second- 
ary cases. 

These  are  known  as  "Koch's  postulates"  and  they  have  been  sat- 
isfied in  the  process  of  identifying  the  causative  organisms  in  a  num- 
ber of  different  diseases. 

The  Laboratory  never  makes  the  diagnosis.  It  tells  the  physi- 
cian whether  or  not  it  finds  the  tubercle  bacilli.  The  physician  con- 
sciously or  sub-consciously  goes  through  this  mental  process: 

"Here  is  a  disease  -which  I  do  not  recognize.  I  have  seen 
the  same  signs  and  symptoms  in  a  number  of  different  causes, 
that  is  to  say,  in  a  number  of  diseases.  Aided  by  the 
laboratory  I  have  found  that  the  bacillus  of  tuberculosis  is  present. 
Therefore,  I  (and  not  the  Laboratory)  make  the  diagnosis  of  tu- 
berculosis." 

FREE  DISTRIBUTION  OF  BIOLOGICS  LIMITED 

At  a  recent  meeting  of  the  State  Board  of  Health  it  was  ordered 
that  after  January  I.  1931,  the  1 500-unit  package  of  tetanus  anti- 
toxin should  be  furnished  only  for  the  indigent.  This  puts  it  on  the 
same  basis  with  other  sera. 

Diphtheria  antitoxin  in  packages  of  10,000  and  5,000  units; 
tetanus  antitoxin  in  packages  of  20,000,  10,000,  and  1,500  units; 
anti-anaerobic  serum  (containing  anti-sera  for  both  gas  bacillus  and 
tetanus)   in   100  c.  c.  and   10  c.  c.  packages;  and  anti-meningococcic 


192 


FLORIDA  STATE  BOARD  OF  HEALTH 


BUREAU  OF  DIAGNOSTIC  LABORATORIES 

serum  in  packages  of  30  c.  c.  are  kept  on  band  and  distributed  for  use 
in  the  treatment  of  indigent  persons  only.  None  of  these  articles  may 
be  sold  by  the  Health  Department, 

Antirabic  treatments,  typhoid  immunization,  vaccine  virus,  toxin  - 
antitoxin  (diphtheria  immunization),  material  for  the  Schick  teat,  and 
carbon  tetrachloride  (treatment  for  hookworms),  are  furnished  free  to 
physicians  without  restriction  as  to  their  use.  In  the  case  of  antirabic 
tr eatRK.it,  it  is  required  that  the  physician  administering  the  treatment 
furnish  the  State  Board  of  Health  with  the  name  and  address  of  the 
person  to  whom  the  treatment  is  administered. 

The  Board  has  designated  more  than  forty  drug  stores  as  official 
Biologic  Stations,  but  keeps  stocks  of  diphtheria  antitoxin  and  ty- 
phoid immunization  only  in  these  stations. 

SUMMARY  OF  WORK  DONE  DURING  THE  MONTH  OF 
OCTOBER,  1930. 

Jacksonville     Tampa      Pensacola      Miami      Tallahassee     Total 

Animal  Parasites  .. 2777 

Diphtheria      ..„. 1759 

Typhoid        _ 3  1  6 

Malaria       44 1 

Rabies      1 4 

Tuberculosis     202 

Gonorrhea      _ 444 

Kahn       3646 

Water :  Count _ 

Water:  Colon 

Milk :  Bacterial  Exam.  1  66 
Milk:  Chemical  Exam. 

Miscellaneous      „..  1  75 


554 

165 

261 

26 

3783 

184 

56 

627 

59 

2685 

145 

40 

80 

88 

669 

195 

38 

15 

142 

831 

2 

16 

67 

5 

54 

24 

352 

231 

43 

129 

26 

873 

501 

137 

549 

5833 

40 

143 
143 

183 
143 

360 

294 

370 
174 

58 

1248 
174 

55 

16 

403 

23 

672 

9940     3334 

Specimen  Containers  Distributed  

Biological  Products  Distribu 


794  2948   446 


17462 
9219 


ted 


Diphtheria  Antitoxin  ..... 

„  10,000 

units 

1  80   Packages 

5,000 

units 

5  2   Packages 

Toxin  Antitoxin  _ 

11058  C.  C. 

Schick 

17160  Tests 

Toxoid _    

540  C.  C. 

Tetanus  Antitoxin 

„  20,000 

units 

2  3   Packages 

1 0,000 

units 

1  6  Packages 

1,500 

units 

7  1  7    Packages 

Typhoid  Vaccine .. 

2240   Treatments 

Vaccine  Virus ...   .. —   — 

4231    Capillaries 

Anaerobic  Virus  — 

.....       1 00 

c.   c. 

5   Packages 

10 

c.    c. 

8    Packages 

Antirabic  Virus 

1  6   Treatments 

2690  Capsules 

FLORIDA  STATE  BOARD  OF  HEALTH 


193 


CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

Lucile  Spire  Blachly,  M.  D.,  Director 

TUBERCULOSIS  AND  MATERNITY 

It  is  interesting  to  note  that  of  the  1,090  deaths  of 
white  women,  ages  15-44,  in  Florida,  in  1928,  the 
chief  cause  of  death  was  childbirth  and  causes  asso- 
ciated with  childbirth,  whereas  of  the  1,465  deaths 
of  colored  'women  in  the  same  age  group,  the  lead- 
ing cause  was  tuberculosis  with  childbirth  and  cau- 
ses associated  with  childbirth,  second.  Tubercu- 
losis ranks  second  as  a  cause  of  death  among  the 
white  women  of  this  age  group. 

ItORIDi 
TEN   LEACDJO  CAUSES  OF  DE13H  AUCHG  YBlilXS.   ACES  IB  -  44, 
AKD  P3R2ENT  07  ™"»  DEATHS  BT  COLOR  -  IMS. 


TEH       CAUSES 


?ISC!«IiOI 


TOSEflOTLOSIS  (AIX  FOOTS) 


HJERFSTUl  STATS 


D1EEA5E3  Of  THE  HEART 


CHRONIC  NEPHRITIS 


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j/mmm////////mmmmmm//m//m//m/A   »« 


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WMBnmnmm  *% 


mmmm 


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TEUAfflA 


cAHciB  (ah  nap] 


RIEOHONIA   (ALL  rQHlE) 


iHTLUaCA  [ALL  FOHE) 


MMt* 


'//mJ/m/m/mm   \\ 


////mm/A 


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4* 


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BCBBi 

COLORED 


)uH»UOr   Klf*LaTi,i»T<tl 


u)/m//mm   It 


zzzzzr 


1       4* 


Similarly,  in  the  deaths  of  white  girls  from  I  5  to  19  years  of 
age  in  the  same  year  the  puerperal  state  appeared  first  with  26%  and 
tuberculosis  third  with  6%,  whereas  among  the  colored  girls  of  the 


194 FLORIDA  STATE  BOARD  OF   HEALTH 

CHILD  HYGIENE  AND  PUBLIC  HEALTH  NURSING 

same  age  group  tuberculosis  came  first  with  25%    and  the  puerperal 
state  second  with   16%. 

Tuberculosis  and  pregnancy  make  a  bad  combination.  Tubercu- 
losis in  the  nursing  mother  is  a  double  menace — a  menace  to  the  mother 
and  a  menace  to  the  baby.  In  most  instances  it  can  be  cured  if  taken 
in  time  but  it  is  much  easier  to  prevent  than  it  is  to  cure. 

What  should  be  done  about  it? 

First.  The  expectant  mother  should  have  a  complete  physical 
examination  as  early  as  she  knows  herself  to  be  pregnant.  This  should 
include  a  careful  study  of  the  chest.  If  the  family  physician  himself 
is  not  especially  interested  or  skilled  in  making  the  chest  examination, 
he  will,  if  requested,  advise  the  patient  to  whom  to  go  for  such  an  exam- 
ination. Take  his  advice;  don't  ask  the  yard  man.  The  yard  man 
may  mean  well  but  he  is  probably  not  in  complete  possession  of  all 
the  facts  concerning  the  diagnostic  ability  of  the  specialists  in  internal 
medicine.  What  then?  Do  as  your  doctor  or  your  doctors  advise. 
Don't  go  around  boasting  of  the  fact  that  they  told  you  thus  and  so 
but  you  didn't  do  it.  That  may  one  time  have  been  considered  "smart" 
in  polite  society  but  in  this  scientific  age,  it  is  proof  positive  of  a  low 
I.  Q. 

Suppose  the  mother  has  tuberculosis  and  suppose  she  gives  birth 

to  a  live  baby.     What  then?      If  the  mother  has  an  open  case that  is, 

if  she  is  coughing  and  bringing  up  sputum — it  is  best,  in  most  instances, 
to  remove  the  baby  from  the  mother  at  once.  Get  a  wet  nurse  if  pos- 
sible. If  not,  supply  artificial  feeding.  This  is  a  job  for  a  pediatri- 
cian to  manage,  preferably,  although  there  are  many  family  physi- 
cians quite  interested  in  babies  and  capable  of  feeding  them  intelli- 
gently. 

What  about  the  mother?  Give  her  every  chance  possible.  This, 
in  the  main,  is  a  matter  of  patience,  rest,  good  food  and  fresh  air. 

What  about  the  older  children,  if  any?  Have  them  all  tuber- 
culin-tested. This  is  much  easier  to  do  than  it  is  to  spell.  It  is  simple, 
takes  but  little  time,  causes  no  distress,  and  helps  a  lot  in  determin- 
ing what  to  do  next.     Ask  your  doctor  about  it. 

In  the  older  cities  and  communities  where  provision  has  been  made 
to  deal  thus  intelligently  with  the  prevention  and  cure  of  tuberculosis,  it 
is  no  unusual  thing  to  see  the  members  of  such  a  family — mother,  baby 
and  older  children — re-united,  well  and  happy,  after  a  period  of  time 
spent  in  "chasing  the  cure". 

Florida  is  too  young  to  have  progressed  far  in  this  matter  but 
even  here  there  is  a  great  deal  that  can  be  done.  If  you  live  in  any 
of  the  cities  call  up  your  city  health  department  and  ask  about  facili- 
ties for  the  indigent.  If  you  live  in  the  country,  write  your  State  Board 
of  Health. 


FLORIDA  STATE   BOARD   OF   HEALTH 


195 


■RECORDS- 

■  s  LO  R  1  D  A  ■ 

BUREAU  OF  VITAL  STATISTICS 
Stewart  G.  Thompson,  D.  P.  H.,  Director 

TUBERCULOSIS  —  ALL  AGES 

Last  year,  a  total  of  1,014  lives  was  taken  in  Florida 
from  tuberculosis  (all  forms);  416  white  and 
598  colored.  Only  twice  in  the  past  decade  have  fewer 
deaths  been  charged  against  tuberculosis  in  this  state. 
In  1925,  there  was  a  total  of  999  and  in  1921  a  total 
of  951,  the  peak  having  been  reached  in  the  year  1926 
with  a  total  of   1,187  deaths  from  this  cause. 

The  more  populous  counties  show  larger  totals.  Duval  County 
shows  173  deaths,  Hillsboro  County  129,  Dade  County  94,  Gadsden 
County  43,  and  Polk  County  42.  Of  the  counties  just  mentioned, 
Hillsboro  has  the  greatest  decrease  with  56  fewer  deaths  from  this 
cause  last  year  than  for  the  previous  year.  Duval  County  is  next  with 
a  decrease  of  1  4  over  the  same  period,  Polk  County  third  with  a  de- 
crease of  I  3.  Gadsden  County  shows  a  decrease  of  1  and  Dade  County 
shows  an  increase  of  5. 

It  is  interesting  to  study  the  ages  affected.  Of  the  white  deaths 
reported  from  tuberculosis  last  year,  13%  fell  into  age  group  35-39, 
1  1  %  in  age  group  20-24,  and  9%  each  in  age  groups  25-29,  30-34, 
and  55-59.  Four  other  age  groups  show  8%,  indicating  less  varia- 
tion in  the  curve  from  age  40  to  64,  inclusive.  The  per  cent  of 
white  deaths  from  this  cause  in  ages  under  20  and  over  70  is  very 
small. 

The  distribution  by  age  groups  among  the  colored  population  var- 
ies considerably.  Nineteen  per  cent  of  the  white  deaths  from  tuber- 
culosis occurred  in  each  of  the  age  groups  20-24  and  25-29.  The 
proportion  among  the  colored  differs  widely  from  the  whites  m  age 
group  15-19  as  there  was  12%  colored  as  compared  with  2%  white 
in  this  group.  The  accompanying  graph  pictures  vividly  the  propor- 
tion of  tuberculosis  deaths  occurring  in  each  age  group  for  both  races. 


The  following  table  indicates  the  number  of  deaths  from  tubercu- 
losis (all  forms)  by  months,  for  1930  as  compared  with  the  previous 
year.      (Provisional  figures.) 

TUBERCULOSIS  DEATHS 


Yew 

Jan.      Feb.      Mar.   Apr.   May   June   July   Aug.   Sept. 

Total     Oel.   Nov.   Dec.      Total 

1930 

1929 

85     89   102  94  92   74  87   73   62 
81    109     88  85  81    76  88  82   71 

1   7581                    j 
761|   80  87  86|1014 

196 


FLORIDA  STATE   BOARD   OF  HEALTH 


BUREAU  OF  VITAL  STATISTICS 


FLORIDA 
PERCENTAGE  07  DEATHS  7ROL5  T0B35CULOSIS   (All  Forma ) 
IN  CERTAIN  AQE  GROUPS,  BT  COLOR  -  1989. 


AGS  GH00PS 


yEHCEKTACES 


10  -  14 


15  -  19 


£0-34 


25-20 


30-34 


35-39 


40-44 


45  -  49 


50-54 


55-59 


60  -  64 


65  -  69 


70  -  74 


75  -  79 


23    IS 


lunfunnmimwrnmnnim   £i 


wmiinnwmmmnmmhmmmmmmmih  S* 


9  % 


nimnnnnmnnmnmnnmmmwmmmm  u* 


n  »t 


////////////////////////////////A 


13  $ 
11  % 


ummmmmmnL 


8  % 


mimmwwimr^  ** 


mmmm 


3  % 

4* 


LEGEND 

WHITE 
COLORED 

mnwh 

iufiwu  or  vital  statistic* 


zzzzzr 


zzzzzzr 


9  % 
2% 


2   •* 

2* 


ZZT 


6* 

a* 


I       3* 

ZZ2 i* 


8* 


FLORIDA   STATE   BOARD   OF   HEALTH 


197 


BUREAU  OF  VITAL  STATISTICS 

PROVISIONAL  MORTALITY  FOR  SEPTEMBER,  *1930 
AS    COMPARED    WITH    SAME    PERIOD    PREVIOUS    YEAR 


Inter- 
national 
Liat  No, 

(1929) 


FLORIDA 


NUMBER    OF    DEATHS 


September.     1910  I     September.    1929 


Tola!  !*Tiite 


Col.   1,  Total 


Of  bile  I   Col. 


GENERAL  MORTALITY   (ALL  ACES) 


1 
1-200   j   ALL  CAUSES 


1-2 

6 
7 
8 
9 

to 

II 
16 
17 
18 
23-32 
38 


Typhoid    ™„ 

Smallpox      

Measles   —..-—..——.■. 

Scarlet  fever  — 

Whooping    cough 
Diphtheria     


Influenza __~_ 

Acute    anterior    poliomyelitis 

Lethargic    encephalitis    

Meningococcus    meningitis    „ 

Tuberculosis — all     forms    

Malaria 


45-53    |    Cancer — all    forms 

62    |    Pellagra 

59 
78-89 

82 

90-103 

90-95 


104- 
107- 

115- 


14 
■  109 

-129 

119 

130-139 

130-132 

140-150 

203  B 


Diabetes    mellitus 

Diseases   of  the    nervous   system   

Cerebral  hemorrhage,  apoplexy  . 
Diseases   of    the    circulatory    system 

Diseases   of    the    heart    — . 


Diseases    of   the   respiratory    system 

Pneumonia — all    forma ....... 

Diseases    of    the    digestive    system 


Diarrhea  and  enteritis    (under   2   years)    .. 
Nonvenereal    diseases    genitourinary   system- 
Nephritis all    forms    — 

The    puerperal    state __~~_ _ — - 

Automobile  and  motorcycle  accidents. 


1332 


10 


2 
68 
46 

75 
18 
16 
141 
117 
215 
192 

50 

32 

I  I  1 

19 

145 

124 

25 

43 


771 


561 


1 
28 
27 

59 
5 

15 

78 

66 

137 

117 

31 
17 
56 
14 
90 
79 
16 
31 


1 

40 
19 

16 
13 
1 
63 
51 
78 
75 

19 
15 
55 

5 
55 
45 

9 
12 


1322 


757 


3 
10 

IS 

1 


71 
72 

66 

17 

9 

128 

88 

178 

160 

63 

49 

113 

II 

152 

125 

23 

37 


29 
40 

56 
S 
9 

79 

53 
104 

93 

32 
26 
63 
6 
85 
67 
10 
35 


INFANT  MORTALITY 

Number  of  LIVE  BIRTHS 
Number  of  STILLBIRTHS 
Number    of   DEATHS    under 


1    year    (all   causes). 


By  cause:    (deaths   under 

l-44.exe.    11.    23.    32a 

II.   23.   32a,    104-114 

118,   119 

157-161 

159 

(60 


I    year) 

Infectious    diseases    — ,.„___ 

Respiratory  diseases  

Gastro-intestinal    diseases    .. 
Malformations    &    early  inf. 

Premature    birth    

Injury  at   birth   — 


242  7 
160 
128 


8 

9 

13 

73 

36 

6 


1678 
71 
74 


5 

5 

10 

46 

26 

5 


749 
89 

54 


3 
4 
3 
27 
10 
1 


2435 
141 
131 


14 

5 

5 

83 

43 

9 


1599 

836 

64 

77 

72 

59 

3 

11 

2 

3 

1 

4 

55 

28 

27 

16 

8 

1 

Includes  delayed  certificates. 


198 


FLORIDA   STATE   BOARD   OF   HEALTH 


BUREAU  OF  VITAL  STATISTICS 

Deaths    from   Tuberculosis    (All    forms)    by   Color   and    by   Counties 

1929. 


COUNTIES 

DEATHS 

Total 

White 

Col. 

0.   State 

1014 
33 
2 
5 
3 
4 

10 

1 
1 

0 
3 

1 

7 

94 

5 

4 

173 

32 

2 
3 
43 
.2 
0 
0 

6 

I 

2 

2 

8 

129 

3 
5 

16 
4 
0 

19 
4 

416 
12 
1 
3 
1 
2 

4 

0 
1 

0 
0 

1 

2 

42 

2 

2 

42 

14 

1 

0 
18 
2 
0 
0 

1 

1 
1 
I 
3 
72 

1 
3 
3 
0 
0 
9 
2 

598 

1 .   Alachua 

21 

?    p»l« 

1 

3.    Bay 

2 

4.  Bradford„„__ 

5.  Brevard 

6.  Broward „™„ 

7.  Calhoun 

55.   Charlotte -    ... 

2 
2 

6 

1 
0 

8.  Citrus 

9.  Clay _. 

62.   Collier 

1  0.    Columbia 

11.  Dade.- 

12.  DeSoto 

■56.    Dixie „__ 

1  3.    Duval 

\4.   CscamBfa ! 

53.   Flagler „~™_™_™ 
15.    Franklin 

0 
3 
0 

5 

52 

3 

2 

131 

16 

1 
3 

1 6.   Gadsden — __ — 
64.   Gilchrist — 
57.   Glades  ..  . 

25 
0 
0 

65.   Cilf           

0 

1  7   Hamilton 

58.  Hardee. 

63.   Hendry. 

1 8.  Hernando...  _ 

59.  Highlands ^„„ 

1 9.  Hillsboro 

20.  Holmes 

66.    Indian  River 

2 1 .  Jackson       ...     . 

22.  Jefferson...... „ 

2  3 .    Lafayette.. ™ 

24.  Lake _ 

25.  Lee 

5 
0 
I 
1 
5 
57 

2 
2 

13 
4 
0 

10 
2 

FLORIDA   STATE  BOARD   OF  HEALTH 


199 


BUREAU  OF  VITAL  STATISTICS 

Deaths   from   Tuberculosis    (All   forms)    by   Color   and  by   Counties 

1929 — (Continued) 


COUNTIES 

DEATHS 

Total 

White 

Col. 

26.   Leon     - 

9 
6 
2 
9 
18 
22 

1 

22 

11 

1 

2 
28 

16 
22 
11 
31 
42 
24 

15 
3 
7 
9 

11 
6 

6 
3 

10 

27 

0 

6 

7 

3 
3 

0 
2 

1  1 
6 

1 

14 

0 

I 

1 

13 

9 
9 
5 

22 

17 

7 

6 
2 
6 
2 
4 
2 

3 

0 
0 
13 
0 
3 
4 

6 

27.  Levy. 

28.  Liberty. 

29.  Madison 

30.  Manatee 

31.  Marion 

67.    Martin 

32.  Monroe 

3 

2 

7 

7 

16 

0 
8 

33.  Nassau 

34.  Okaloosa .    _ 

54.   Okeechobee 

3  5 .   Orange „.. 

36.  Osceola... 

37.  Palm  Beach 

38.  Pasco 

11 

0 
I 

15 

7 

13 

6 

39.  Pinellas „. 

40.  Polk         

41.  Putnam „ 

42.  St.  Johns... 

9 

25 
17 

9 

43.  St.  Lucie _ „... 

44.  Santa  Rosa 

60.  Sarasota 

45.  Seminole „   

46.  Sumter. 

47.  Suwannee „.. 

48.  Taylor 

6 1 .  Union 

49.  Volusia     

1 

1 
7 
7 
4 

3 

3 

10 

14 

50.  Wakulla - 

51.  Walton... 

5  2 .   Washington 

0 
3 

3 

TUBERCULOSIS  DEATHS  (All  Forms)  By  A 

?c_1929 

Ages     |-l|J-4|5-9|!0-14|15-19t20-29|30-39|40-49|50-591 

60-f|Unk|   Total 

Total     |  6|     8]     5|         9        76|     31  1|     21  1|     161 1     104| 

116     |     7   |    1014 

200 


HUMAN  LIFE  IS  THE  STATE'S  GREATEST  ASSET 


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9    - 

LO 

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AOffilSTM&S 
DRSWINGGAM& 

Start  drawing  from  the  dot  on  Line  Z  to  where 
lines  3  and  C  meet  (that  is  3-C)  ani  thcn?^ 
proceed  in  Older  of  numbers  given  below. 
When  finished  cocredfy.  It  null  he  a 
portrait  of  someone  w  ail  know. 


SOUffJH 

DOT- 

THEI1D 

5-B 

9-E 

3H 

5D 

8F 

5-H 

3-C 

K 

6-F 

5-F 

3-B 

6B 

5-H 

4F 

4B 

fi-A 

2-F 

4E 

4D 

9-A 

1-D 

3-E 

5-E 

9-B 

1-1 

2-C 

4-D 

8C 

2-J 

ID 

4C 

9< 

31 

Do* 

HiaiLy 


.g^lHealth.- 
JJjistmas  1 


©  A.P.H.A. 


INDIX 
19  3  0 


-A- 


Page 


Activities,  Program  of  {Bureau  of  Child  Hygiene 

and  Public  Health  Nursing) 140 

Age  Group  1-4,  Deaths 45 

Ages  Affected  by  Tuberculosis 195 

Aid,  Laboratory 190 

American  Child  Health  Association  Conference 

for  the  State  May  Day  Chairmen 71,88 

Announcement  -  Water  Works  Men • 38 

Annual  Board  Meeting 36 

Annual  Meeting  (59th)  of  American  Public 

Health  Association,  Ft. Worth, Texas, Oct. 27, 1930  14 

Anonymous  Communications 87 

Another  War? 188 

AntJ^Mosquito  Association,  Florida,  Meeting  ....  37 

Anti-Babies  Inoculations 19 

Antirabic  Treatments  Free 12 

A.P.H.A.,  59th  Annual  Meeting  (Notice  of  Date)  .  14 

Assessment,  Hookworm  ....,.*... 92 

Attention  -Druggists 35 

Automobile  Accidents 74,135 

Average  Life  Span  Shorter 28 

-B- 

Babceck,  Dr.  Stephen  Moulton 110 

Bacteria  in  Milk  126,142 

Believe  It  or  Not 146 

Bill  of  Rights,  Child's 53 

Biologies  Distribution 36 

Biologies  Free  Distribution  Limited 191 

Births  -  1929  ...  96 

Board  Meeting,  Annual 36 

Board  Meeting,  Echoes  from 3 

Boosts  and  Knocks , 155 

Bran  Muffins  Suitable  for  Diabetic  Patients  ...  76 

Broadcasting  Germs ,.  75 

Brown,  Henry  P.,  First  Twenty-year  Bnployee  of 

State  Board  of  Health  since  Dr. Jos. Y.Porter  .  9 

Business  is  Goodl 7 

-0- 

Cancer  (All  Forms) 134 

Capper  Prize  Ill 


INDEX 
19  3  0 


-C- 


Page 


Cartoons 

A  Fable 60 

A  Healthier  World  120 

A  Little  Drawing  Lesson  165 

American  Junior  Bed  Cross  184 

A  Page  for  the  Children  32,168 

A  Page  for  the  Children  -  Christmas  Draw- 
ing Game  -  A  Merry  Xmas  200 

A  Page  for  the  Children  -  Health  Limericks  100 

Bill  Jones  Comes  Home  30 

Consult  your  Doctor  and  Avoid  Danger  16 

Diagram  of  a  Delicate  Machine  * 152 

Early  Diagnosis 16 

Every  Day  of  the  Year  in  Florida 136 

Halloween  Trip  to  the  stars •  168 

Hookworm  Infestation  and  Disease 48 

Juniors  Helping  Everywhere 184 

Little  Talks  About  Big  Diseases  62 

Make  your  own  "Good  Health"  Valentine  ....  32 

Prize  Winner  -  Health  Limericks 100 

See  your  Doctor  for  Spare  Parts 152 

The  Wormy  Way  48 

Uncle  Doc  136 

We  Know  How  to  Clean  House,  But- 120 

Willie  and  the  "Schick  Test"  62 

Causes  of  Death  in  Florida  -  1929,  Ten 

Leading  132 

Cerebral  Hemorrhage  133 

Certificate  Forms,  New  (Birth  and  Death)  ....  13 

Child  Health  Council  39 

Child  Hygiene  -  prelude  52 

Child  Hygiene  Week  in  South  Jacksonville  ....  173 

Children,  What  Doctors  Have  Done  for  them  ...  77 

Children* s  Weight,  Swimming  Reduces  156 

Child's  Bill  of  Rights 53 

Chronic  Nephritis  133 

Circus,  A  Health 57 

Circus,  The 35 

Clinics  -  Tuberculosis 131 

Communicable  Diseases 75 

Communications,  Anonymous 87 

Communities  having  Sewer  Systems 158,159 


-3- 

INDEX 
19  3  0 


-C- 


Page 


Conclusions  (Bureau  of  Child  Hygiene  and  Public 

Health  Nursing)  . , i  5 

Conference  for  the  State  May  Day  Chairmen 

(American  Child  Health  Association)  71,88 

Conference  of  the  Surgeon  General  and  the 

State  and  Provincial  Health  Officers  124 

Conference,  State  -  Social  Y»ork  *«#«•*»» 37 

Council,  Health,  and  Florida  Health  Problems  . .  84 

Council,  The  Health ,..., 53 

County  Health  Service • 5? 

Coupon  -  For  requesting  Maternity  Letters  . ....  161 

Coupon  -  For  Revision  of  Mailing  List  . 45 

Creeping  Eruption 74,130 

-D- 

Danger  in  American  Life .„ 97 

Deaths,  Age  Group  1-4 45 

Deaths  -  1929 76 

Deficiency  of  Diet  -  Pellagra 163 

Demonstration  for  Malaria  Control,  Screening  . .  91 

Demonstrations  -  The  Reason  for 146 

Dessert  at  End  of  Meal,  Why  We  Eat 8 

Diabetic  Patients,  Bran  Muffins  Suitable  for  ».  76 

Diphtheria  Deaths  ......  ,.„.. -  •  •  •  14 

Diphtheria  Deaths,  January -November,  1928-1929,  30 

Diphtheria  Deaths,  January -February,  1930  &.  1929  97 

Diphtheria  Deaths,  January -April,  1930  and  1929  118 

Diphtheria  Deaths,  January-August,  1930  &  1929  182 

DiphthfTla  Immunization  .*...,. 145 

Diphtheria  Immunization,  importance  of  ........  20 

Diphtheria  Virulence  Test  11 

Dl sease  Tax 91 

Diseases  of  Early  Infancy 135 

Distribution  of  Biologies 36 

Distribution  of  Biologies  (Free)  Limited  ......  191 

Divorces  and  Marriages  ........................  61 

Doctor  of  Ft.  Pierce  Congratulated  .......... ...  13 

Doctors  are  Honest .....,_.......  145 

Doctors  Please  Note 12 

Does  It  Fay? ............  20 

Drowning .  .  .  .  .  ...  .  .  74 

Drug  stores 35 


_4- 

INDEX 
19  3  0 

Page 
-E- 

Early  Sign  of  Pellagra 181 

Echoes  from  the  Board  Meeting  ...............  3 

Economics,  Health 23 

Economics,  Health  and 171 

Economy  and  Health •*** 139 

Enabling  Act ,  57 

Error,  Regrettable 193 

Eventually  Smallpox  Will  Return 147 

Examination  of  Milk  110 

Exclusion  of  school  Children,  Requests  for  ..  19 

Expectant  Mothers,  Letters  for  •  125,141,161 

-F- 

Ficld  Notes  (Engineering)  175 

Field  Program  (Child  Hygiene  and  Public 

Health  Nursing) 173 

First  Twenty-year  SJnployoe  of  State  Board  of 

Health  since  Dr.  Joseph  Y.  Porter  .........  9 

Florida  and  Tuberculosis 144 

Florida  Anti-Mosquito  Association,  Meeting  of  37 

Florida  Healthier 117 

Florida  Health  Problems  and  the  Health  Coun- 
cil   84 

Ft.  Pierce  Mosquito  Control  ,. 24 

Free  Distribution  of  Biologies  Limited  ......  191 

Function  of  a  State  Laboratory 40 

-G- 

Gerra  Market,  The .*...........,...*•  11 

Germs,  Broadcasting ,. 75 

Grow  Old  Happily 165 

-H- 

Hair,  Methods  of  Removing 90 

Handicap  of  Indifference 91 

Health  and  Economi cs  ........................  171 

Health  and  Economy 139 

Health  Circuf,  A 57 

Health  Conference,  Statewide ►.*, •  103 


-5- 
INDEX 

19  3  0 


-11- 


Page 


Health  Council  ......  1 1 1 ....♦! 53 

Health  Council  and  Florida  Health  Problems  «..  84 

Health  Economi cs  ...u 23 

Healthier  Florida,  A  t* , ti«....  117 

Healthmobile  hii.i.i. ..tint....  10 

Health  News  iil.mii* tU  li. ...  51 

Health  Notes  Bound  -  I'd*  Librarians  •  *  tl Jif  i ••  Z$ 

Health  Pictures  42 

Health  Service,  County <  57 

Health  Show,  How  to  Get  the 42 

Health  Stressed  by  Many  Organizations * .  67 

Heart  Disease 132 

High  School  Age  Mortality 164 

Hookworm  Assessment 92 

Hookworm  Blues ............  58 

Hookworm  Disease  -  Millions  for  Defense  162 

Hope  and  Tuberculosis  187 

Housec leaning,  Spring 72 

How  Diseases  Are  Spread  ,,...... 11 

How  Much  for  Tribute? 162 

Hew  Necessary  is  Illness? 123 

-I- 

Illness,  How  Necessary  Is  It? , 123 

Indifference,  The  Handicap  of .  , 91 

Infantile  paraiysi s  181 

Infant  Mortality  Lower  in  1929  182 

Influenza  (All  Forms) 134 

Institute,  Public  Health 30 

interesting  Movies 42 

-K- 

Killed  by  Motor  Vehicles  149 

Killers,  Ten  Leading ., 132 

Knocks  and  Boosts 155 

-L- 

Laboratories,  Diagnostic,  Summary  of  Examina- 
tions ...  9,21,41,55,56,70,90,111,127,143,178,179,192 

Laboratory  Aid  , ,..,  190 


INDEX 
19  3  0 

Page 
-L- 

Laboratory  in  Medicines,  Ifce  Place  of  the  .  t...  177 

Laboratory  Notes * it... 54 

Letters,  Maternity .  ». .  125,141,161 

Life  Savers I  • 58 

Life  Span  Shorter,  Average i;*. 28 

Little  Talks  About  Big  Diseases  ,..j 62 

Local  Registrars  Appointed 4......*.*... 

Local  Registrars,  Notice 45 

Looking  Backward  Over  Fifty  Years  of  Health 

Work  in  Florida 43,59 

Love  Apple,  The •  145 

-Mc- 

McCord,  Dr.  J.  Rk  u.wu Li.  108,124 

-M- 

Mailing  List,  Revision  of  .*.i....4...... 45 

Make  Nuts  Part  of  Daily  Mopu 11 ; .  ,76 

Malaria *  * . 89 , 130 ,  135 

Malaria,  A  Hint  on  1* . ... t i...... 11 

Malaria,  Control  Screening  Demonstration t  91 

Malaria  Doaths  *  i  * . . •••*••••* 1 1 i  i  » * • •« 4 • I  14 

Malaria  Deaths*  January-November,  1928-1929  . .  30 

Malaria  Deaths,  January-February,  1930  &  1929  97 

Malaria  Deaths,  January-April,  1930  and  1929  »  118 

Malaria  Deaths,  January- August,  1930  and  1929  182 

Malaria  in  tha  Unitod  States 51 

Malta  Fever  and  Tularemia  Reportable  Diseases  11 

Marriages  and  Divorces 61 

Maternal  Mortali  ty  Surveys  109 

Maternity  and  Tuberculosis  193 

Maternity  Letters 125,141,161 

May  Day 39 

Measles 112 

Medicine,  The  place  of  the  Laboratory  in 177 

Mooting  of  State  Public  Health  Association  ...  83 

Meeting 67 

Methods  of  Removing  Hair 96 

Milk  -  Bacteria 126,142 

Milk  Examination 110 

Millions  for  Defense 162 


-7- 

INDEX 

19  3  0 


-M- 


Page 


Monkey  Farm  at  Orange  Park,  Yale  Establishes  .  .*  30 

Morbid! ty  Reports  . 163 

Mortality  for  March,  1930,  Provisional  . . 119 

Mortality  for  November,  1929,  Provisional  31 

Mortality,  Infant,  Lower  in  1S29 182 

Mortality  in  the  High  School  Age . 164 

Mortality,  Provisional,  for  October,  1929  ......  15 

Mortality  Surveys,  Maternal  «... • 109 

:  Mosquito  Control  at  Ft.  Pierce 24 

Mosquito  Meeting * 37 

Mosquito-proofing  Your  Home 73 

Motor  Vehicle  Deaths 149 

Movies,  Health 10 

Movies,  Interesting 42 

-N- 

New  Birth  and  Death  Certificate  Forms  13 

New  Local  Registrars  Appointed 77 

New  program  in  the  Field,  The  173 

New  public  Health,  The  22 

New  School  Buildings 93 

News,  Health • 51 

Note  on  Laboratory  Teohnique 69 

Notice  to  Doctors 11 

Notice  to  Local  Registrars 45 

Now  is  the  Time  to  Teach  Vacation  Hygiene  87 

Nuts  Part  of  Daily  Menu  76 

-0- 

Obstetrical  Course,  postgraduate 108,124 

One  Way  of  Doing  It  113 

-P- 

Pellagra  163 

Pellagra  an  Economic  Problem  ...................  180 

pellagra  Prevention 180 

Personality,  Danger  of  Crushing 97 

Physical  Examination  Blanks  for  Teachers  .......  160 

Pictures,  Health ,. 42 

Place  of  the  Laboratory  in  Medicine 177 


INDEX 

1130 

Page 
-P- 

Plants  for  Water  Purification  ........... ..   114 

Pneumonia  (All  Forme) • 134 

Foi eon  Ivy  .............. 75 

Postgraduate  Obstetrical  Course  108,124 

Prelude  *  Child  Hygiene  52 

Preventive  Measures  against  Infectious  Diseases  181 

Prevent  Pellagra  ...................... 180 

Preventive  Treatment  or  Prophylaxis  (Syntereeis)  10 

Problems,  Health  and  the  Health  Council  ......  84 

Program  in  the  Field,  The  New 173 

Program  of  Activities,  Bureau  of  Child  Hygiene 

and  Public  Health  Nursing  •  140 

Projected  Rural  Health  Program 104 

Prophylaxis  or  Preventive  Treatment  (Synteresis)  10 

Prophylaaftie  and  Therapeutic  Measures 19 

Provisional  Mortality  for  March,  1930  , 119 

Provisional  Mortality  for  Octeber,  1929  15 

Provisional  Mortality  for  November,  1929  31 

Public  Health  Association,  State  ...,.,.».««..  83 

Public  Health  Institute  3« 

Public  Health,  The  New 22 

Pupils  Appreciate  Health  Movies  • ••#•■•••  11 

-R- 

Rables  , .  ... 68 

Regrettable  Error  ..*, 190 

Remember  (Diphtheria  Iramrnization) 145 

Report  snippings 175 

Reportable  Diseases  -  Undulant  Fever  and 

Tularemia  ......................*..*»....•..  11 

Requests  for  Exclusion  of  School  Children  . ...  19 

Review  -  Looking  Backward  Over  Fifty  Years  of 

Health  Work  in  Florida  43 

Revision  of  Mailing  List 45 

Rose,  Dr.  David  ..................a 11 

Rule  No.  101  {sanitation  of  School  Buildings).  94 

Rural  Health  Program,  Projected ...*••  104 

-S- 

Sanitation  of  School   Buildings »••  93 

Schedule  of  Screening  Demonstrations  .........  130 


I  fet  D  E  X 

19  3  0 


-S- 


Page 


Schick  Test,  Willie  and  the  62 

School  Buildings,  New 93 

School  Children,  Requests  for  Exclusion  of  ..       19 
Screening  Demonstration  for  Malaria  Control  .       91 

Screening  Demonstrations  Malaria . .  130 

Seminoles,  The  . 131 

Sewage  Disposal  and  Sewerage  in  Florida, 1930.  128,147,157 
Sewerage  and  Sewage  Disposal  in  Florida, 1930.  128,147,157 

Smallpox  Will  Return  Eventually 147 

Snippings  from  Reports 175 

Social  Work  -  State  Conference  37 

Spring  House  Cleaning 

State  Board  of  Health  Circus  . • 35 

State  Conference  -  Social  iroric 37 

State  Laboratory,  Function  of  a 40 

Statement  of  Ownarship,  Management, 

Circulation,  etc ...        61 

State  Public  Health  Association 83 

Statewide  Health  Conference 103 

Sunburn ...........................       74 

Surgssn  c»oj!rnl '  a  and  the  State  and  provincial 

Health  Officers*  Conferonco 124 

Surveys,  Maternal  Mortality ♦,.....  109 

Swimming  Reduces  Children's  Weight  156 

Syntoresis 10 


Tables  and  Charts 

Automobile  Accidents  135 

Cancer  (All  Forms)  134 

Cerebral  Hemorrhage  133 

Deaths  from  Automobile  Accidents  in  Florida 

by  Color  and  by  Counties  -  1929 150,151 

Deaths  from  Tuberculosis  (All  Forms)  by 

Color  and  by  Countios  -  1929 198,199 

Diphtheria  Deaths,  January-February, 1930 

and  1929 ,       97 

Diphtheria  Deaths,   January-April,   1930  and 

1929 118 

Diphtheria  Deaths,  January- August,  1930 

and  1929  ,      182 

Diphtheria  Deaths,  January-Octabor, 

1938-1929  14 


-10- 
INDEX 

19  3  0 

Paga 
-T- 

Tables  and  Charts  (Continued) 

Diphtheria  Deaths,  January-November, 1928-1929  30 

Diseases  of  Early  Infancy ,•..,.......  135 

Heart  Disease 132 

Influenza  (All  Forms )  134 

Leading  Causes  of  Death  in  Ago  Group  1-4, 

1928,  by  Sex  and  by  Color 46,47 

Leading  Causes  of  Death  in  Are  Group  15-19, 

1929,  by  Sox  and  by  Color 166,167 

Malaria  ..,....,. 135 

Malaria  Deaths, January-February, 1930  and  1929  97 

Malaria  Deaths,  January- April, 1930  and  1929  118 

Malaria  Deaths,  January-August, 1930  and  1929  182 

Malaria  Deaths,  January-October, 1928-1929  ..  14 

Malaria  Deaths,  January-November,  1928-1929  30 
Marriages  performed  {by  color),  Divorces  and 

Annulments  Granted,  by  counties  -  1929  ...   63,64* 

Mortality  Provisional  for  August,  1930  183 

Mortality  provisional  for  October,  1929  ....      15 
Mortality  Provisional  for  November,  1929  ...      31 

Nephritis.  Chronic  133 

Percentage  of  Deaths  from  Tuberculosis  {All 

Forms)  in  Certain  Ago  Groups  by  Color,  1929     196 

Pneumonia  (All  Forms) «...     134 

Provisional  Mortality  for  LIarch11930  as  com- 
pared with  March,  1929 119 

Provisional  Mortality  for  September,  1930 

as  compared  with  September,  1929 197 

Ton  Leading  Causes  of  Doath  Among  Females, 

ages  15-44  and  per  cont  of  Female  Deaths 

by  Color,  1928 193 

Ton  Loading  Causes  of  Doath,  Florida,  1929  .     132 
Total  Births  (Exclusive  of  Stillbirths)  by 

Color  and  by  Countios,  1929  98,99 

Total  Deaths  by  Color  and  by  Counties,  1929   78,79 

Tuberculosis  {All  Forms)  133 

Tuberculosis  Deaths,  January-February, 1930 

and  1929  97 

Tuberculosis  Deaths,  January- April, 1930  and 

1929 118 

Tuberculosis  Doaths, January- August ,1930  and 

1929 182 

Tuberculosis  Deaths,  January-Soptomber,1930 

and  1929 , 195 


INDEX 
1  9 '3  0 


-T- 


Pogo 


Tables  and  Charts  (Continued ) 

Typhoid  Deaths,  January-November,  1988-1929 
Typhoid  Doaths,  January-February,  1930  and 

192  9 

Typhoid  Doaths,  January-Aprilt1930  and  1929 
Typhoid  Deaths,  January-August ,1930  and  1929 
Typhoid  Doaths,  January-October,   1928-1929. 

Tax  of  Disease,  The  

Teachers  Cooperate 

Teachers,  Physical  Examination  Blanks  for  .... 
Tochnique,  Laboratory  (Note  on)  .............. 

Ton  Loading  Killers 

Therapeutic  and  Prophylactic  Measures  ........ 

Time  to  Teach  Vacation  Hygiene 

Toe  Itch 

To  Librarians 

Toraetoos,  The  Love  Apple 

To  Roport  or  Not  to  Report  ••••••• • 

Toxoid ;,, 

Traffic  in  Germs  -,...„,...,.,.. 

Tuberculosis,  Ail  Ages 

Tuberculosis  (All  Forma)  . 68 

Tuborculosis  and  Florida 

Tuberculosis  and  Hope  ••<*»•«••• * 

Tuberculosis  and  Maternity 

Tuberculosis  Clinics 

Tuborculosis  Doaths,  January -February,  1930 

and  1929 

Tuborculosis  Doaths,  January-April,  1930  and 

1929  

Tuberculosis  Deaths.   January-Augpst,   1930  and 

1929 '. 

Tuberculosis  Doaths,   Januory-Soptembor,  1930 

and  1929   

Tuborculosis,  Tho  V/ar  Against 

Tularemia  and  Undulant  Fever, Report able  Disoasos 
Twenty-Year  Employee,  Tho  First  since  Dr. 

Joseph  Y.  Porter 

Typhoid  Doaths,  January-October,  1928-1929  ... 
Typhoid  Deaths,  Jonuary-Hovembor,  1928-1929  .. 
Typhoid  Doaths,  January-February, 1930  and  1929 
Typhoid  Deaths,  January-April,  1930  and  1929  . 
Typhoid  Deaths,  January -August,  1930  and  1929 


30 

97 

118 

182 
14 
91 
75 

160 
69 

132 
19 
07 

130 
29 

145 

163 
42 
11 

195 
,133,188 

144 

187 

193 

131 

97 

118 

182 

195 

188 

11 

9 

14 
30 

97 
118 
182 


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-12- 
I  NT)  E  X 
19  3  0 

Pago 
-V- 

Undulant  Fevor  and  Tularemia,  Reportable  Diseases  11 

Unusual  Items  in  Field  Engineering  Reports  . ..»  175 

-V- 

Vacation  Hygiene,  Now  is  the  Time  to  Toach  »•«•  87 

Vacation  Jolts V ...«#  74 

Vacation  Time  **♦» . 74 

Virulence  Test  ,.... U 

-W- 

Weter  Analysis  IM, 73 

Water  Purification  Plants  in  Florida 114 

Water  Works  Men  -  Attt=nt  ion 33 

What  Doctors  Have  Done  for  Children -77 

What  is  Health? ,, 26 

What  of  the  Summer? »••••? .....*....*  74 

7iiij.cid. $n,  Dr.  L.  L.  *.*.«..*■>•.•««*■•«**...*•*•  13 

Who  Cares? 162 

Why  the  Demonstrations? k...  146 

Why  We  Eat  Dessort  at  End  of  Meal .-..,.  8 

Willie  and  the  Schick  Test  .,,....» 62 

Work  To  Be  Done  ..,. 7 

-Y- 

Tfale  Establishes  Monkey  Faim  at  Orange  Park  ...  30